Higher cumulative fluid balance in ICU patients with sepsis tied to major adverse kidney events

Key findings:

• 519 (28.3%) patients developed MAKE30.
• Median (IQR) cumulative fluid balance was 5.3 (2.8–8.1) l in the MAKE30 group and 4.1 (1.9–6.8) l in the no MAKE30 group, with non-resuscitation fluids contributing to approximately half of the total fluid input in each group.
• The adjusted odds ratio for MAKE30 was 1.05 per liter cumulative fluid balance.
• The strongest factors regarding MAKE30 were, in decreasing order, baseline creatinine, cumulative fluid balance, and age on relative importance analysis.
• The adjusted odds ratio for dialysis or sustained renal dysfunction was 1.06 per liter cumulative fluid balance in the secondary outcome analysis.
• Lower urine output and early acute kidney injury, respectively, were independently associated with MAKE30, whereas higher fluid input was not on separate sensitivity analyses.

Thus the researchers concluded that patients in ICU with sepsis had a higher cumulative fluid balance after 2 days in ICU and were associated with subsequent development of major adverse kidney events within 30 days. Death, renal replacement requirement, or persistent renal dysfunction were also associated with the adverse events.

For the full article, click here: https://doi.org/10.1186/s13613-022-01040-6

Mele, A., Cerminara, E., Häbel, H. et al. Fluid accumulation and major adverse kidney events in sepsis: a multicenter observational study. Ann. Intensive Care 12, 62 (2022).