Intravenous Fluids and Acute Kidney Injury

Xiaoqiang Ding, Zhen Cheng, Qi Qian

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Over 50% of the human body is comprised of fluids that are distributed in defined compartments. Although compartmentalized, these fluids are dynamically connected. Fluids, electrolytes, and acid-base balance in each compartment are tightly regulated, mostly in an energy-dependent manner to achieve their designed functions. For over a century, our understanding of the microvascular fluid homeostasis has evolved from hypothesized Ernest Starling principle to evidence-based and the revised Starling principle, incorporating the functional endothelial surface layer. The kidney is a highly vascular and encapsulated organ that is exquisitely sensitive to inadequate (insufficient or excess) blood flow. The kidney is particularly sensitive to venous congestion, and studies show that reduced venous return triggers a greater degree of kidney damage than that from lacking arterial flow. Thus, fluid overload can induce severe and sustained kidney injury. In the setting of established acute kidney injury, fluid management can be challenging. Impaired capacity of urine output and urine concentration and dilution should be taken into consideration when designing fluid therapy. Video Journal Club 'Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=452702.

Original languageEnglish (US)
Pages (from-to)163-172
Number of pages10
JournalBlood Purification
Volume43
Issue number1-3
DOIs
StatePublished - Mar 1 2017

Keywords

  • Acute kidney injury
  • Critically ill patients
  • Intravenous fluids
  • Starling principle
  • Volume assessment
  • Volume overload

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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