Influence of Fluid Balance on Morbidity and Mortality in Critically Ill Patients With Acute Kidney Injury

Abstract

Introduction. Fluid management in critically ill patients with acute kidney injury (AKI) is controversial. Our study is aimed to evaluate the association between fluid balance and patient outcome in AKI patients admitted to intensive care unit (ICU).

Materials and Methods. This prospective study was carried out at Lilavati Hospital and Research Centre on 130 critically ill patients with AKI admitted to ICU. Mean daily fluid balance (MDFB) was measured and its correlation with clinical characteristics and outcomes was assessed.

Results. During ICU stay, 48.2% patients had a positive and 52.8% had a negative MDFB. In the patients with positive MDFB, mean ICU stay was longer and ventilation requirement, duration of ventilation, inotrope requirement, and duration of inotrope were greater as compared to the group with negative MDFB. A significantly higher mortality rate were observed in the patients with positive MDFB as compared to negative MDFB (43.5% versus 7.4%).

Conclusions. Negative fluid balance was independently associated with a significant reduction in mortality, ICU stay, ventilator requirement, and the need for renal replacement among critically ill patients with AKI.