Fluid Balance and Outcomes in Acute Renal Failure
Author Information
Author(s): Payen Didier, de Pont Anne Cornélie, Sakr Yasser, Spies Claudia, Reinhart Konrad, Vincent Jean Louis
Primary Institution: CHU Lariboisière, University of Amsterdam, Friedrich-Schiller-University Jena, Charité-Universitätsmedizin Berlin, Université libre de Bruxelles
Hypothesis
Does fluid management influence mortality in critically ill patients with acute renal failure?
Conclusion
A positive fluid balance is associated with increased 60-day mortality in patients with acute renal failure.
Supporting Evidence
- Patients with acute renal failure had a 60-day mortality rate of 35.7%, compared to 16.4% in those without.
- Mean daily fluid balance was significantly more positive among non-survivors than survivors.
- Oliguric patients had higher mortality rates and more positive fluid balances than non-oliguric patients.
- Patients treated with early renal replacement therapy had shorter ICU stays and lower mortality rates.
Takeaway
If patients with kidney problems get too much fluid, they might not do as well. It's better for them if they get the right amount of fluid.
Methodology
This was a multicenter observational cohort study analyzing data from the SOAP study, focusing on patients with acute renal failure in ICUs.
Potential Biases
Potential biases may arise from the non-standardized management of fluid balance and the observational nature of the study.
Limitations
The study is observational and cannot establish causation between fluid balance and mortality.
Participant Demographics
The study included adult ICU patients from 198 ICUs across 24 European countries, with a mean age of 60.6 years.
Statistical Information
P-Value
<0.01
Confidence Interval
95% CI for fluid balance: 1.13–1.28
Statistical Significance
p<0.01
Digital Object Identifier (DOI)
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