ArticlePloS one2018
Aggressive fluid accumulation is associated with acute kidney injury and mortality in a cohort of patients with severe pneumonia caused by influenza A H1N1 virus.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Prevalence of acute kidney injury in Mexico; a systematic review and meta-analysis of pre-pandemic reports.Renal failure · 2025Pooled it
- Acute kidney injury in patients with COVID-19 compared to those with influenza: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Non-interventional follow-up versus fluid bolus in RESPONSE to oliguria in hemodynamically stable critically ill patients: a randomized controlled pilot trial.Critical care (London, England) · 2022Trial
- The ageing immune system and its battle with viruses.The Journal of general virology · 2026Review
- Personalized Fluid Management in Patients With Sepsis and Acute Kidney Injury: A Causal Machine Learning Approach.Critical care explorations · 2025Article
- Virus-Associated Nephropathies: A Narrative Review.International journal of molecular sciences · 2022Review
- Association between Latent Trajectories of Fluid Balance and Clinical Outcomes in Critically Ill Patients with Acute Kidney Injury: A Prospective Multicenter Observational Study.Kidney diseases (Basel, Switzerland) · 2022Article
- Sodium Toxicity in the Nutritional Epidemiology and Nutritional Immunology of COVID-19.Medicina (Kaunas, Lithuania) · 2021Article
- Aging and respiratory viral infection: from acute morbidity to chronic sequelae.Cell & bioscience · 2021Review
- Pragmatic Recommendations for the Prevention and Treatment of Acute Kidney Injury in Patients with COVID-19 in Low- and Middle-Income Countries.The American journal of tropical medicine and hygiene · 2021Article
- Acute Kidney Injury and Renal Replacement Therapy in COVID-19 Versus Other Respiratory Viruses: A Systematic Review and Meta-Analysis.Canadian journal of kidney health and disease · 2021Article
- Observational
- Mechanistic Aspects and Therapeutic Potential of Quercetin against COVID-19-Associated Acute Kidney Injury.Molecules (Basel, Switzerland) · 2020Review
- Tissue-resident CD8Science immunology · 2020Article
- Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study.Infectious diseases · 2020Article
- Prevalence and mortality due to acute kidney injuries in patients withInternational journal of health sciencesReview
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFluid accumulation is associated with adverse outcomes such as acute kidney injury (AKI) in critically ill patients. This study aimed to describe the factors associated with AKI in individuals with influenza A H1N1 severe pneumonia, and explore the relation of fluid accumulation with AKI and mortality. MATERIAL AND
methodsWe reviewed medical records of individuals with influenza A H1N1 severe pneumonia and no history of chronic kidney disease, attending a national referral center for respiratory diseases between November 2014 and May 2015. Demographic information, risk factors for AKI, physiologic and laboratory data, outcomes and information on fluid intake and output were recorded. Categorical variables were compared using the chi-square test. Quantitative variables were compared using the Mann-Whitney test. Factors associated with AKI and mortality were identified by binary logistic regression. Linear models of fluid accumulation rates for individuals and groups were estimated using segmented linear regression.
resultsOf 60 patients studied, 43 developed AKI (71.6%). Male gender was protective for AKI (p = 0.019). AKI was associated with nephrotoxic drugs (p = 0.016); PEEP>10 cm H2O on admission (p = 0.031); mortality (p = 0.037); and fluid accumulation ≥10% (fluid overload) at day 7 of hospitalization (p = 0.00026). Mortality was associated with older age (p = 0.009); nephrotoxic drugs (p = 0.034); and higher Pneumonia Severity Index score (112 vs. 76, p = 0.008) on admission. The Deceased-AKI group had a higher rate of fluid accumulation (expressed as ml/kg/body weight) than the Survivors-No AKI group during the study period of 7 days (Survivors-No AKI = 13.31 vs. Deceased-AKI = 22.76, p = 0.019). During the highest phase of fluid accumulation, the Survivors-No AKI group had a slower rate of fluid accumulation than the Survivors-AKI group (14.91 vs. 28.49, p = 0.001).
conclusionsA high rate of fluid accumulation was associated with AKI and mortality. We support the approach of resuscitation in acute illness, with an early transition to neutral and then negative fluid balances.
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