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- ÁvilaMaria Olinda NogueiraMON0000-0001-7818-7344LIM 12, Disciplina de Nefrologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.Monte Tabor Hospital Sao Rafael, Salvador, BA, BR.Universidade do Estado da Bahia, Salvador, BA, BR, Paulo Novis Rocha, Caio A Perez, Tássia Nery Faustino, BatistaPaulo Benigno PenaPBP0000-0003-3394-1774Monte Tabor Hospital Sao Rafael, Salvador, BA, BR.Faculdade de Medicina, Uniao Metropolitana de Educacao e Cultura UNIME/KROTON, Lauro de Freitas, BA, BR.Faculdade de Medicina, Uniao Metropolitana de Educacao, Luis Yu, Dirce Maria T Zanetta, and Emmanuel A Burdmann.
- LIM 12, Disciplina de Nefrologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
- Clinics (Sao Paulo). 2021 Jan 1; 76: e1924.
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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