ArticleClinics (Sao Paulo, Brazil)2021
Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients.
Article in Clinics (Sao Paulo, Brazil), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- A prediction model for 30-day mortality of sepsis patients based on intravenous fluids and electrolytes.Medicine · 2022Trial
- Extended venous excess ultrasound: A promising addition to point-of-care ultrasound-based venous congestion assessment.World journal of cardiology · 2026Review
- Modification of the Cardiac Renal Angina Index for Predicting Adverse Kidney Events After Pediatric Cardiac Surgery.Journal of the American Heart Association · 2025Observational
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Authors and funding
8 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPositive fluid balance is frequent in critically ill patients and has been considered a potential biomarker for acute kidney injury (AKI). This study aimed to evaluate positive fluid balance as a biomarker for the early detection of AKI in critically ill patients.
methodsThis was a prospective cohort study. The sample was composed of patients ≥18 years old who stayed ≥3 days in an intensive care unit. Fluid balance, urinary output and serum creatinine were assessed daily. AKI was diagnosed by the Kidney Disease Improving Global Outcome criteria.
resultsThe final cohort was composed of 233 patients. AKI occurred in 92 patients (40%) after a median of 3 (2-6) days following ICU admission. When fluid balance was assessed as a continuous variable, a 100-ml increase in fluid balance was independently associated with a 4% increase in the odds of AKI (OR 1.04; 95% CI 1.01-1.08). Positive fluid balance categorized using different thresholds was always significantly associated with subsequent detection of AKI. The mixed effects model showed that increased fluid balance preceded AKI by 4 to 6 days.
conclusionThese results suggest that a positive fluid balance might be an early biomarker for AKI development in critically ill patients.
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Registered trials
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