Fluid Overload and Acute Kidney Injury

Vijaya P Patil, Bindiya G Salunke, Vijaya P Patil, Bindiya G Salunke

Abstract

Commonest intervention in hospitalized patient is fluid therapy, and practically every critically ill patient receives fluid resuscitation. Commonest indication for fluid administration is to achieve hemodynamic stability and prevent or manage acute kidney injury (AKI). However, fluid administration is a two-edged sword, i.e., inadequate fluids give rise to hypoperfusion and organ injury and overzealous fluid therapy can give rise to fluid overload and related consequences. Though fluids are commonly given to prevent development of AKI, hypervolemia itself has the potential to cause AKI.

How to cite this article: Patil VP, Salunke BG. Fluid Overload and Acute Kidney Injury. Indian J Crit Care Med 2020;24(Suppl 3):S94-S97.

Keywords: Acute kidney injury; Fluid movement; Fluid overload; Renal blood flow.

Conflict of interest statement

Source of support: Nil Conflict of interest: None

Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.

Figures

Flowchart 1
Flowchart 1
Pathophysiology of hypervolemia and AKI

References

    1. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al. Beginning and ending supportive therapy for the kidney (BEST kidney) investigators: acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005;294(7):813–818. doi: 10.1001/jama.294.7.813. DOI:
    1. Kaufman J, Dhakal M, Patel B, Hamburger R. Community-acquired acute renal failure. Am J Kidney Dis. 1991;17(2):191–198. doi: 10.1016/s0272-6386(12)81128-0. DOI:
    1. Ostermann M, Straaten HMO, Forni LG. Fluid overload and acute kidney injury: causes and consequence? Crit Care. 2015;19(1):443. doi: 10.1186/s13054-015-1163-7. DOI:
    1. Wang N, Jiang L, Zhu B, Wen Y, Xi XM The Beijing acute kidney injury trial (BAKIT) workgroup. Fluid balance and mortality in critically ill patients with acute kidney injury: a multicenter prospective epidemiological study. Crit Care. 2015;19(1):371. doi: 10.1186/s13054-015-1085-4. DOI:
    1. Alobaidi R, Morgan C, Basu RK, Stenson E, Featherstone R, Majumdar SR, et al. Association between fluid balance and outcomes in critically ill ChildrenA systematic review and Meta-analysis. JAMA Pediatr. 2018;172(3):257–268. doi: 10.1001/jamapediatrics.2017.4540. DOI:
    1. Payen D, de Pont AC, Sakr Y, Spies C, Reinhart K, Vincent JL, et al. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care. 2008;12(3):R74. doi: 10.1186/cc6916. DOI:
    1. Prowle JR, Chua HR, Bagshaw SM, Bellomo R. Clinical review: volume of fluid resuscitation and the incidence of acute kidney injury - a systematic review. Crit Care. 2012;16(4):230. doi: 10.1186/cc11345. DOI:
    1. Chappell D, Bruegger D, Potzel J, Jacob M, Brettner F, Vogeser M, et al. Hypervolemia increases release of atrial natriuretic peptide and shedding of the endothelial glycocalyx. Crit Care. 2014;18(5):538. doi: 10.1186/s13054-014-0538-5. DOI:
    1. Berg S, Golster M, Lisander B. Albumin extravasation and tissue washout of hyaluronan after plasma volume expansion with crystalloid or hypooncotic colloid solutions. Acta Anaesthesiol Scand. 2002;46(2):166–172. doi: 10.1034/j.1399-6576.2002.460207.x. DOI:
    1. Krogh A, Landis EM, Turner AH. The movement of fluid through the human capillary wall in relation to venous pressure and to the colloid osmotic pressure of the blood. J Clin Invest. 1932;11(1):63–95. doi: 10.1172/JCI100408. DOI:
    1. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med. 2017;45(3):486–552. doi: 10.1097/CCM.0000000000002255. DOI:
    1. Langenberg C, Wan L, Egi M, May CN, Bellomo R. Renal blood flow in experimental septic acute renal failure. Kidney Int. 2006;69(11):1996–2002. doi: 10.1038/sj.ki.5000440. DOI:
    1. Langenberg C, Wan L, Egi M, May CN, Bellomo R. Urinary biochemistry in experimental septic acute renal failure. Nephrol Dial Transplant. 2006;21(12):3389–3397. doi: 10.1093/ndt/gfl541. DOI:
    1. Salahuddin N, Sammani M, Hamdan A, Joseph M, Al-Nemary Y, Alquaiz R, et al. Fluid overload is an independent risk factor for acute kidney injury in critically ill patients: results of a cohort study. BMC Nephrol. 2017;18(1):45. doi: 10.1186/s12882-017-0460-6. DOI:
    1. Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. definitions. Intensive Care Med. 2006;32(11):1722–1732. doi: 10.1007/s00134-006-0349-5. DOI:
    1. Sugrue M, Jones F, Deane SA, Bishop G, Bauman A, Hillman K. Intra-abdominal hypertension is an independent cause of postoperative renal impairment. Arch Surg. 1999;134(10):1082–1085. doi: 10.1001/archsurg.134.10.1082. DOI:
    1. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P Acute Dialysis Quality Initiative workgroup. Acute dialysis quality initiative workgroup: acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the acute dialysis quality initiative (ADQI) group. Crit Care. 2004;8(4):R204–R212. doi: 10.1186/cc2872. DOI:
    1. Bradley SE, Bradley GP. The effect of increased intra-abdominal pressure on renal function in man. J Clin Invest. 1947;26(5):1010–1022. doi: 10.1172/JCI101867. DOI:
    1. Doty JM, Saggi BH, Sugerman HJ, Blocher CR, Pin R, Fakhry I, et al. Effect of increased renal venous pressure on renal function. J Trauma. 1999;47(6):1000–1003. doi: 10.1097/00005373-199912000-00002. DOI:
    1. Winton FR. The influence of venous pressure on the isolated mammalian kidney. J Physiol. 1931;72(1):49–61. doi: 10.1113/jphysiol.1931.sp002761. DOI:
    1. Firth JD, Raine AE, Ledingham JG. Raised venous pressure: a direct cause of renal sodium retention in oedema? Lancet. 1988;1(8593):1033–1035. doi: 10.1016/s0140-6736(88)91851-x. DOI:
    1. Butcher BW, Kathleen DL. Fluid overload in AKI: epiphenomenon or putative effect on mortality?. current opinion. Crit Care. 2012;18:593–598.
    1. Himmelfarb J, McMonagle E, Freedman S, Klenzak J, McMenamin E, Le P, et al. The PICARD group. oxidative stress is increased in critically ill patients with acute renal failure. J Am Soc Nephrol. 2004;15(9):2449–2456. doi: 10.1097/01.ASN.0000138232.68452.3B. DOI:

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