Fluid balance and chloride load in the first 24 h of ICU admission and its relation with renal replacement therapies through a multicentre, retrospective, case–control study paired by APACHE-II

Abstract

Abstract Objective To analyse the association between water balance during the first 24 h of admission to ICU and the variables related to chloride levels (chloride loading, type of fluid administered, hyperchloraemia), with the development of acute kidney injury renal replacement therapy (AKI-RRT) during patients’ admission to ICU. Patients and methods Multicentre case–control study. Hospital-based, national, carried out in 6 ICUs. Cases were patients older than 18 years who developed an AKI-RRT. Controls were patients older than 18 years admitted to the same institutions during the study period, who did not develop AKI-RRT during ICU admission. Pairing was done by APACHE-II. An analysis of unconditional logistic regression adjusted for age, sex, APACHE-II and water balance (in evaluating the type of fluid). Results We analysed the variables of 430 patients: 215 cases and 215 controls. An increase of 10% of the possibility of developing AKI-RRT per 500 mL of positive water balance was evident (OR: 1.09 [95% CI: 1.05–1.14]; p Conclusions The water balance in the first 24 h of ICU admission relates to the development of IRA-TRR, regardless of chloraemia.