The impact of fluid balance on the detection, classification and outcome of acute kidney injury after cardiac surgery

Elizabeth Madeleine Moore, Antony Tobin, David A Reid, John Santamaria, Eldho Paul, Rinaldo Bellomo

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49 Citations (Scopus)


Objective To assess whether or not a positive fluid balance masks acute kidney injury (AKI) and is associated with adverse outcomes after cardiac surgery. Design Retrospective analysis. Setting Tertiary university-affiliated metropolitan hospital: single center. Participants Three thousand two hundred seven consecutive cardiac surgical patients admitted to the ICU from July 1, 2004 to June 30, 2012. Interventions None. Measurements and Main Results The authors used AKI Network criteria to classify AKI. They then adjusted creatinine levels for weight-corrected fluid balance and categorized patients into 3 groups: group A (No AKI); group B (AKI only after adjustment); group C (AKI before and after adjustment). No patients had AKI before but No AKI after adjustment. Among 2,171 patients with weight and baseline creatinine available, after adjusting for fluid balance, the proportion of patients classified with AKI increased from 25.3 to 37.2 (p
Original languageEnglish
Pages (from-to)1229 - 1235
Number of pages7
JournalJournal of Cardiothoracic and Vascular Anesthesia
Issue number5
Publication statusPublished - 2015

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