Hourly fluid balance in patients receiving continuous renal replacement therapy

Thummaporn Naorungroj, Ary Serpa Neto, Lara Zwakman-Hessels, Fumitaka Yanase, Glenn Eastwood, Rinaldo Bellomo

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1 Citation (Scopus)


Introduction: Little is known about early (first 48 h) hourly and cumulative fluid balance (FB) during continuous renal replacement therapy (CRRT). Objectives: To study the characteristics and outcome associations of early hourly and cumulative FB. Methods: We studied FB in CRRT patients (2016-2018). Results: Among 350 patients, mean hourly FB became negative after 20 CRRT hours, but within 6 CRRT hours in patients with baseline fluid overload. A negative early FB was never achieved in patients receiving vasopressor therapy (p < 0.001). Mortality was 31%. The percentage of hourly negative FB was independently associated with decreased ICU mortality. A time-weighted hourly FB between 18.5 and -33 mL/h was also significantly and independently associated with decreased mortality. Conclusions: In CRRT patients, an early FB conservative approach is possible, modulated by patient characteristics, and associated with a low mortality. Moreover, avoidance of an early positive FB is associated with decreased mortality.

Original languageEnglish
Pages (from-to)93-101
Number of pages9
JournalBlood Purification
Issue number1-2
Publication statusPublished - Feb 2020


  • Continuous renal replacement therapy
  • Fluid overload
  • Hourly fluid balance
  • Mortality
  • Vasopressors

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