ReviewNephron2019
Acute Kidney Injury and Fluid Resuscitation in Septic Patients: Are We Protecting the Kidney?
Review in Nephron, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Effect of restrictive fluid resuscitation on severe acute kidney injury in septic shock: a systematic review and meta-analysis.BMJ open · 2025Pooled it
- Effects of low-dose furosemide combined with aminophylline on the renal function in septic shock patients.Renal failure · 2023Trial
- Restrictive fluids versus standard care in adults with sepsis in the emergency department (REFACED): A multicenter, randomized feasibility trial.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Trial
- The impact of urine output trajectory on clinical outcomes in female patients with genitourinary infections in the intensive care unit.Scientific reports · 2026Article
- MiR-760 protects against lipopolysaccharide-induced septic acute kidney injury by targeting ENKD1.Clinical and experimental nephrology · 2025Article
- Development and validation of a machine-learning-based model for identification of genes associated with sepsis-associated acute kidney injury.Frontiers in genetics · 2025Article
- Acute kidney injury and early fluid load in a retrospective cohort of neonatal sepsis.Pediatric nephrology (Berlin, Germany) · 2023Article
- Stomach, liver, kidney and skeletal muscle autoregulation evaluated by near-infrared spectroscopy in a swine model.Journal of clinical monitoring and computing · 2023Article
- [Predictive scale of acute kidney failure in sepsis (ARMO)].Revista de salud publica (Bogota, Colombia) · 2023Article
- Comprehensive Management of Blood Pressure in Patients with Septic AKI.Journal of clinical medicine · 2023Review
- Effects of mesencephalic astrocyte-derived neurotrophic factor on sepsis-associated acute kidney injury.World journal of emergency medicine · 2023Article
- Performance of the renal resistive index and usual clinical indicators in predicting persistent AKI.Renal failure · 2022Article
- SARS-CoV-2 infection and diabetes: Pathophysiological mechanism of multi-system organ failure.World journal of virology · 2022Review
- No association between intravenous fluid volume and endothelial glycocalyx shedding in patients undergoing resuscitation for sepsis in the emergency department.Scientific reports · 2022Article
- Effect of fluid load on the prognosis of children with sepsis-associated acute kidney injury undergoing continuous renal replacement therapy.Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2022Article
- Identifying the molecular mechanisms of sepsis-associated acute kidney injury and predicting potential drugs.Frontiers in genetics · 2022Article
- Influence of the trajectory of the urine output for 24 h on the occurrence of AKI in patients with sepsis in intensive care unit.Journal of translational medicine · 2021Article
- Effects of impaired microvascular flow regulation on metabolism-perfusion matching and organ function.Microcirculation (New York, N.Y. : 1994) · 2021Review
- Impact of Cumulative Fluid Balance During Continuous Renal Replacement Therapy on Mortality in Patients With Septic Acute Kidney Injury: A Retrospective Cohort Study.Frontiers in medicine · 2021Article
- Septic acute kidney injury: a review of basic research.Clinical and experimental nephrology · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
Acute kidney injury (AKI) is a common complication in critically ill patients, especially among septic patients. Sepsis and hypovolemia are the 2 most frequent etiologies of AKI in intensive care units and frequently coexist in critically ill patients. Effective fluid resuscitation is crucial for the stabilization of sepsis-induced tissue hypoperfusion or septic shock. However, the lack of a goal-directed therapy targeting kidney oxygenation prevents from optimization of the fluid therapy with regard to improvement of renal oxygen delivery and extraction. Similarly, fluid administration as all therapeutic actions carries adverse effects such as the activation of cytokines, disruption of the capillary glycocalyx, and adverse effects on kidney metabolism and oxygenation. Moreover, a positive fluid balance is associated with an increased risk of AKI and is a negative predictor for recovery of renal function. The role of fluid resuscitation on kidney injury stems from the high renal vulnerability to hypoxemic injury. Indeed, fluids have a poor oxygen solubility and hemodilution decreases blood viscosity both promoting intrarenal shunting and heterogeneity with a decreased capillary density and enhanced intrarenal cortex and medullary hypoxia. The development of physiological biomarkers that are able to detect the early development of AKI specifically aimed at the identification of renal microcirculatory dysfunctions should form a valuable contribution to monitoring therapeutic modalities.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.