ArticleCritical care (London, England)2016
Hyperchloremia and moderate increase in serum chloride are associated with acute kidney injury in severe sepsis and septic shock patients.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04507672 (Acetated Ringer's Solution Versus Saline in Patients With Septic Shock), which is not on this map. Cited by 97 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Acetated Ringer's Solution Versus Saline in Patients With Septic Shock
Who cites it
97 citing papers in PubMed, 2 syntheses or guidelines pooled it, 177 citations in OpenAlex.
- Balanced crystalloid versus saline for resuscitation in adult sepsis: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Dysregulated serum chloride and clinical outcomes in critically ill adults: A systematic review and meta-analysis.PloS one · 2025Pooled it
- Effect of Saline vs Gluconate/Acetate-Buffered Solution vs Lactate-Buffered Solution on Serum Chloride Among Children in the Pediatric Intensive Care Unit: The SPLYT-P Randomized Clinical Trial.JAMA pediatrics · 2023Trial
- Impact of continuous hypertonic (NaCl 20%) saline solution on renal outcomes after traumatic brain injury (TBI): a post hoc analysis of the COBI trial.Critical care (London, England) · 2023Trial
- Hypertonic sodium lactate improves microcirculation, modulates inflammation, and preserves vascular reactivity in a rat model of sepsis: in vivo and ex vivo evidence.Intensive care medicine experimental · 2026Article
- Early identification of acute kidney injury progression in critically ill patients with sepsis: interpretable machine learning approach.Clinical kidney journal · 2026Article
- Early osmotherapy exposure and subsequent incident acute kidney injury in neurocritical care patients: a MIMIC-IV retrospective cohort study.Journal of intensive care · 2026Article
- Perioperative hyperchloremia is associated with acute kidney injury in elderly patients undergoing bipolar plasmakinetic transurethral resection of the prostate: a prospective observational study.World journal of urology · 2026Observational
- J-shaped association between serum bicarbonate and 28-day ICU mortality in adult patients with sepsis: A multicenter cohort analysis.Medicine · 2026Article
- Article
- L-shaped association between serum chloride levels with 30-day and 365-day all-cause mortality in septic patients with liver cirrhosis.BMC infectious diseases · 2026Article
- Chloremia Disturbances in Critical Care: A Narrative Review of Pathophysiology, Clinical Impact and Management Strategies.Life (Basel, Switzerland) · 2026Review
- Association of early chloride-bicarbonate joint phenotypes with in-hospital mortality among intensive care unit patients with sepsis: a dual-database study.Frontiers in medicine · 2026Article
- Initial serum chloride is associated with all-cause mortality in critically ill patients with acute kidney injury.Renal failure · 2025Article
- Impact of fluid creep on volume and chloride load in critically ill adults: a prospective study on its prognostic significance and association with MAKE30.Renal failure · 2025Article
- Review
- Predicting In-Hospital Mortality in Intensive Care Unit Patients Using Causal SurvivalNet With Serum Chloride and Other Causal Factors: Cross-Country Study.Journal of medical Internet research · 2025Article
- Comparison of 5% sodium bicarbonate and 10% sodium chloride as contrast agents for lung perfusion with electrical impedance tomography: a prospective clinical study.BMC pulmonary medicine · 2025Article
- Electrolyte disorders in the critically ill: a retrospective analysis.Scientific reports · 2025Article
- Contribution of intravenous medication diluent fluid composition on the development of dyschloremia in intensive care unit patients: A retrospective chart review.SAGE open medicine · 2025Article
37 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute kidney injury and hyperchloremia are commonly present in critically ill septic patients. Our study goal was to evaluate the association of hyperchloremia and acute kidney injury in severe sepsis and septic shock patients.
methodsIn this retrospective cohort study in a provincial tertiary care hospital, adult patients with severe sepsis or septic shock and serum chloride measurements were included. Serum chloride was measured on a daily basis for 48 hours. Primary outcome was development of acute kidney injury (AKI) and association of AKI and serum chloride parameters was analyzed.
resultsA total of 240 patients were included in the study, 98 patients (40.8 %) had hyperchloremia. The incidence of acute kidney injury (AKI) was significantly higher in the hyperchloremia group (85.7 % vs 47.9 %; p < 0.001). Maximal chloride concentration in the first 48 hours ([Cl
conclusionsHyperchloremia is common in severe sepsis and septic shock and independently associated with AKI. A moderate increase in serum chloride (Δ[Cl
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