Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients

Detalhes bibliográficos
Autor(a) principal: Ávila, Maria Olinda Nogueira
Data de Publicação: 2021
Outros Autores: Rocha, Paulo Novis, Perez, Caio A., Faustino, Tássia Nery, Batista, Paulo Benigno Pena, Yu, Luis, Zanetta, Dirce Maria T., Burdmann, Emmanuel A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/191702
Resumo: OBJECTIVES: Positive 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. METHODS: This was a prospective cohort study. The sample was composed of patients X18 years old who stayed X3 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. RESULTS: The 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. CONCLUSION: These results suggest that a positive fluid balance might be an early biomarker for AKI development in critically ill patients.
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spelling Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patientsAcute Kidney InjuryBiomarkerPositive Fluid BalanceWater BalanceIntensive Care UnitMortalityOBJECTIVES: Positive 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. METHODS: This was a prospective cohort study. The sample was composed of patients X18 years old who stayed X3 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. RESULTS: The 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. CONCLUSION: These results suggest that a positive fluid balance might be an early biomarker for AKI development in critically ill patients.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2021-11-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/19170210.6061/clinics/2021/e1924Clinics; Vol. 76 (2021); e1924Clinics; v. 76 (2021); e1924Clinics; Vol. 76 (2021); e19241980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/191702/176627Copyright (c) 2021 Clinicsinfo:eu-repo/semantics/openAccessÁvila, Maria Olinda Nogueira Rocha, Paulo Novis Perez, Caio A. Faustino, Tássia Nery Batista, Paulo Benigno Pena Yu, Luis Zanetta, Dirce Maria T. Burdmann, Emmanuel A. 2023-07-06T13:04:08Zoai:revistas.usp.br:article/191702Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-07-06T13:04:08Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
title Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
spellingShingle Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
Ávila, Maria Olinda Nogueira
Acute Kidney Injury
Biomarker
Positive Fluid Balance
Water Balance
Intensive Care Unit
Mortality
title_short Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
title_full Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
title_fullStr Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
title_full_unstemmed Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
title_sort Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
author Ávila, Maria Olinda Nogueira
author_facet Ávila, Maria Olinda Nogueira
Rocha, Paulo Novis
Perez, Caio A.
Faustino, Tássia Nery
Batista, Paulo Benigno Pena
Yu, Luis
Zanetta, Dirce Maria T.
Burdmann, Emmanuel A.
author_role author
author2 Rocha, Paulo Novis
Perez, Caio A.
Faustino, Tássia Nery
Batista, Paulo Benigno Pena
Yu, Luis
Zanetta, Dirce Maria T.
Burdmann, Emmanuel A.
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Ávila, Maria Olinda Nogueira
Rocha, Paulo Novis
Perez, Caio A.
Faustino, Tássia Nery
Batista, Paulo Benigno Pena
Yu, Luis
Zanetta, Dirce Maria T.
Burdmann, Emmanuel A.
dc.subject.por.fl_str_mv Acute Kidney Injury
Biomarker
Positive Fluid Balance
Water Balance
Intensive Care Unit
Mortality
topic Acute Kidney Injury
Biomarker
Positive Fluid Balance
Water Balance
Intensive Care Unit
Mortality
description OBJECTIVES: Positive 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. METHODS: This was a prospective cohort study. The sample was composed of patients X18 years old who stayed X3 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. RESULTS: The 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. CONCLUSION: These results suggest that a positive fluid balance might be an early biomarker for AKI development in critically ill patients.
publishDate 2021
dc.date.none.fl_str_mv 2021-11-09
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/191702
10.6061/clinics/2021/e1924
url https://www.revistas.usp.br/clinics/article/view/191702
identifier_str_mv 10.6061/clinics/2021/e1924
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/191702/176627
dc.rights.driver.fl_str_mv Copyright (c) 2021 Clinics
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2021 Clinics
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 76 (2021); e1924
Clinics; v. 76 (2021); e1924
Clinics; Vol. 76 (2021); e1924
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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