ArticleBMC nephrology2013
Higher serum chloride concentrations are associated with acute kidney injury in unselected critically ill patients.
Article in BMC nephrology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
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Who cites it
52 citing papers in PubMed, 110 citations in OpenAlex.
- Sodium Bicarbonate Prevents Contrast-Induced Nephropathy in Addition to Theophylline: A Randomized Controlled Trial.Medicine · 2016Trial
- The Clinical and Metabolic Derangements after Using 0.9% Normal Saline as Maintenance Intravenous Fluid in Children.Annals of African medicine · 2026Article
- Sepsis in critically ill dogs: identification of clinical and laboratory risk factors and evaluation of sepsis scoring systems.Journal of veterinary internal medicine · 2026Article
- Chloremia Disturbances in Critical Care: A Narrative Review of Pathophysiology, Clinical Impact and Management Strategies.Life (Basel, Switzerland) · 2026Review
- Timing of lactated Ringer's administration relative to Sepsis-3 diagnosis and 28-day mortality: A retrospective propensity score-matched cohort study.SAGE open medicine · 2026Article
- Article
- Sodium and chloride disturbances in critically ill adult patients: A protocol for a sub-study of the FLUID-ICU cohort study.Acta anaesthesiologica Scandinavica · 2025Article
- Is there a relationship between hyperchloremia status and the risk of developing acute kidney injury in pediatric patients with diabetic ketoacidosis?European journal of pediatrics · 2024Article
- Inverse association between serum chloride levels and the risk of atrial fibrillation in chronic kidney disease patients.Clinical kidney journal · 2024Article
- Modified del Nido cardioplegia is associated with low incidence of low main strong ion difference and hyperchloremia in pediatric patients after cardiac surgery.Journal of anesthesia · 2024Article
- L-Shaped Association of Serum Chloride Level With All-Cause and Cause-Specific Mortality in American Adults: Population-Based Prospective Cohort Study.JMIR public health and surveillance · 2023Article
- Hyperchloremia and association with acute kidney injury in critically ill children.Pediatric nephrology (Berlin, Germany) · 2023Article
- Electrolyte derangements in critically ill children receiving balanced versus unbalanced crystalloid fluid resuscitation.BMC nephrology · 2022Observational
- A burden of fluid, sodium, and chloride due to intravenous fluid therapy in patients with respiratory support: a post-hoc analysis of a multicenter cohort study.Annals of intensive care · 2022Article
- Balanced Crystalloids versus Normal Saline in Adults with Sepsis: A Comprehensive Systematic Review and Meta-Analysis.Journal of clinical medicine · 2022Review
- Acute and sub-acute oral toxicity of aqueous whole leaf and green rind extracts of Aloe vera in Wistar rats.BMC complementary medicine and therapies · 2022Article
- Hyperchloremia is associated with poor renal outcome after coronary artery bypass grafting.BMC nephrology · 2021Article
- Subtyping Hyperchloremia among Hospitalized Patients by Machine Learning Consensus Clustering.Medicina (Kaunas, Lithuania) · 2021Article
- Association between the use of balanced fluids and outcomes in critically ill children: a before and after study.Critical care (London, England) · 2021Article
- Perioperative Renoprotection: General Mechanisms and Treatment Approaches.Anesthesia and analgesia · 2020Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChloride administration has been found to be harmful to the kidney in critically ill patients. However the association between plasma chloride concentration and renal function has never been investigated.
methodsThis was a retrospective study conducted in a tertiary 24-bed intensive care unit from September 2010 to November 2012. Data on serum chloride for each patient during their ICU stay were abstracted from electronic database. Cl0 referred to the initial chloride on ICU entry, Cl(max), Cl(min) and Cl(mean) referred to the maximum, minimum and mean chloride values before the onset of AKI, respectively. AKI was defined according to the conventional AKIN criteria. Univariate and multivariable analysis were performed to examine the association of chloride and AKI development.
resultsA total of 1221 patients were included into analysis during study period. Three hundred and fifty-seven patients (29.2%) developed AKI. Cl(max) was significantly higher in AKI than in non-AKI group (111.8 ± 8.1 vs 107.9 ± 5.4 mmol/l; p < 0.001); Cl0 was not significantly different between AKI and non-AKI patients; Cl(mean) was significantly higher in AKI than non-AKI (104.3 ± 5.8 vs 103.4 ± 4.5; = 0.0047) patients. Cl(max) remained to be associated with AKI in multivariable analysis (OR: 1.10, 95% CI: 1.08-1.13).
conclusionChloride overload as represented by Cl(mean) and Cl(max) is significantly associated with the development of AKI.
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