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Crit Care Clin. 2018 Apr;34(2):279-298. doi: 10.1016/j.ccc.2017.12.006. Epub 2018 Feb 3.

Does Fluid Type and Amount Affect Kidney Function in Critical Illness?

Author information

1
Department of Intensive Care, Austin Hospital, 145 Studley Road, Heidelberg, Melbourne, VIC 3084, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Australian and New Zealand Intensive Care Research Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia.
2
Department of Intensive Care, Austin Hospital, 145 Studley Road, Heidelberg, Melbourne, VIC 3084, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Australian and New Zealand Intensive Care Research Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia; School of Medicine, The University of Melbourne, Grattan Street and Royal Parade, Melbourne, VIC 3010, Australia. Electronic address: Rinaldo.bellomo@austin.org.au.

Abstract

Acute kidney injury (AKI) is common, although commonly used clinical diagnostic markers are imperfect. Intravenous fluid administration remains a cornerstone of therapy worldwide, but there is minimal evidence of efficacy for the use of fluid bolus therapy outside of specific circumstances, and emerging evidence associates fluid accumulation with worse renal outcomes and even increased mortality among critically ill patients. Artificial colloid solutions have been associated with harm, and chloride-rich solutions may adversely affect renal function. Large trials to provide guidance regarding the optimal fluid choices to prevent or ameliorate AKI, and promote renal recovery, are urgently required.

KEYWORDS:

Acute kidney injury; Albumin; Balanced solution; Colloid; Crystalloid; Hydroxyethyl starch; Intravenous fluid therapy; Succinylated gelatin

PMID:
29482907
DOI:
10.1016/j.ccc.2017.12.006
[Indexed for MEDLINE]

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