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Abstract: TH-PO061

Relationship Between the Rate of Fluid Resuscitation and AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Reddy, Swetha, Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
  • Kashani, Kianoush, Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
Background

Septic shock is the leading cause of acute kidney injury (AKI) in critically ill patients. While fluid resuscitation has become the cornerstone of early septic shock management, the association between fluid resuscitation rates and kidney outcomes remains unclear. This investigation examines the relationship between fluid resuscitation rate and AKI resolution

Methods

We retrospectively studied adult (≥ 18 years) patients with AKI and septic shock, defined based on sepsis III definition, from January 1, 2006, through May 31, 2018, in the medical intensive care unit (MICU) of Mayo Clinic Rochester. The fluid resuscitation time was defined as the time required to infuse the initial fluid bolus of 30 ml/kg, based on the recommendations of the surviving sepsis campaign. The cohort was divided into three groups based on the average fluid resuscitation time (<1hr, 1.1-2hr, >3hr) and the corresponding fluid rate ≥ 0.5, 0.25–0.49, and < 0.17 ml/kg/min, respectively. The primary outcome was the recovery of AKI on day 7

Results

597 patients met eligibility criteria and were included in the analysis. The AKI recovery was significantly different among the groups (P 0.006). Patients in groups 1 and 2 who received fluid resuscitation faster had a higher rate of AKI recovery (53% and 50%) when compared with group 3 (37.8%)

Conclusion

In septic shock patients with AKI, an initial fluid resuscitation rate of 0.25–0.50 ml/kg/min (i.e, completion of the initial 30 ml/kg IV fluid resuscitation within the first two hours) is associated with higher AKI recovery compared with slower infusion rates