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Year : 2019  |  Volume : 1  |  Issue : 3  |  Page : 81-88

Fluid Overload and Acute Kidney Injury, Chicken or Eggs?

1 Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China
2 Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA

Correspondence Address:
Dr. Xuelian Liao
No.37 Guo Xue Xiang, Chengdu, Sichuan 610041
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jtccm.jtccm_9_19

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Fluid overload is one of the main complications associated with intravenous fluid therapy. Weight-based fluid accumulation is often calculated for fluid balance status in most researches. Fluid overload was defined as more than a 10% increase in body weight relative to baseline. There are many evidences that fluid overload is associated with an increased risk of acute kidney injury (AKI) and mortality. This review focuses on the pathophysiological link between fluid overload and AKI. Disruption of endothelial glycocalyx induced by fluid overload plays an important role in AKI. In addition, the compositions of the fluids (some colloids and chloride-rich fluids) may also contribute to kidney injury. On the other side, fluid overload is more obvious and the outcome in patients with AKI or with more critical illness. Therefore, the relationship between fluid overload and AKI should be fully understood and carefully managed.

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