Abstract: FR-PO0083
Treatment of AKI During a Nationwide Intravenous Fluid Shortage
Session Information
- AKI: Epidemiology and Clinical Trials
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Neiderman, George G., University at Buffalo, Buffalo, New York, United States
- Panesar, Jay, Williamsville Central School District, East Amherst, New York, United States
Background
Hurricane Helene of September 2024 resulted in severely damaging a major intravenous fluid manufacturing plant which caused a nationwide fluid shortage. Consequently, healthcare systems were encouraged to implement conservation strategies such as to increase the use of oral versus intravenous hydration in clinically applicable situations.
Methods
An oral hydration order set was implemented in the electronic health record in a tertiary care academic medical center to encourage and facilitate the use of oral fluids for the treatment of acute kidney injury. Order set usage rates were tabulated and compared to the frequency of orders placed for intravenous fluids in patients with a diagnosis of acute kidney injury during the nationwide fluid shortage from October to December 2024. During this time, the length of stay was also compared for acute kidney injury patient diagnosed on admission treated with oral versus intravenous hydration. Lastly, the rate of improvement in renal function was compared between the two groups.
Results
The oral hydration order set was used 6.8% (3/44) of the time in patients admitted with acute kidney injury. The length of stay in the oral hydration group was 16.3 days versus 8.7 days in intravenous group (p value 0.245, effect size -0.706). Also, there was no statistically significant difference in the length of stay for both groups (oral and intravenous) between the shortage and the pre-shortage time periods. Days to achieve a serum creatinine level of less than 1.5 mg/dL was 4.4 days for the intravenous group versus 2.3 days in the oral hydration group.
Conclusion
Oral hydration order sets proved to be ineffective in changing practitioner behavior for the treatment of acute kidney injury even in the setting of a nationwide crisis. Intravenous fluids remained the treatment of choice for acute kidney injury.