Positive fluid balance is an independent risk factor for acute kidney injury in critically ill patients: results of a prospective, cross-sectional study

Salahuddin, Nawal; Sammani, Mustafa; Hamdan, Ammar; Joseph, Mary; Alnemary, Yasir; Alquaiz, Rawan; Maghrabi, Khalid

doi:10.1186/cc14270

Cited by 2 publications

(1 citation statement)

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“…17 Finally, the retrospective nature of the study prohibited us from accurately assessing fluid balance, which has been identified as an independent risk factor for AKI in critically ill patients. 22…”

Section: Discussionmentioning

confidence: 99%

Nephrotoxic Risk Associated With Combination Therapy of Vancomycin and Piperacillin-Tazobactam in Critically Ill Patients With Chronic Kidney Disease

Pipkin,

Pope,

Killian

et al. 2024

J Intensive Care Med

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Background: The combination of vancomycin and piperacillin-tazobactam (VPT) has been associated with acute kidney injury (AKI) in hospitalized patients when compared to similar combinations. Additional studies examining this nephrotoxic risk in critically ill patients have not consistently demonstrated the aforementioned association. Furthermore, patients with baseline renal dysfunction have been excluded from almost all of these studies, creating a need to examine the risk in this patient population. Methods: This was a retrospective cohort analysis of critically ill adults with baseline chronic kidney disease (CKD) who received vancomycin plus an anti-pseudomonal beta-lactam at Emory University Hospital. The primary outcome was incidence of AKI. Secondary outcomes included stage of AKI, time to development of AKI, time to return to baseline renal function, new requirement for renal replacement therapy, intensive care unit and hospital length of stay, and in-hospital mortality. Results: A total of 109 patients were included. There was no difference observed in the primary outcome between the VPT (50%) and comparator (58%) group ( P = .4), stage 2 or 3 AKI (15.9% vs 6%; P = .98), time to AKI development (1.7 vs 2 days; P = .5), time to return to baseline renal function (4 vs 3 days; P = .2), new requirement for RRT (4.5% vs 1.5%; P = .3), ICU length of stay (7.3 vs 7.4 days; P = .9), hospital length of stay (19.3 vs 20.1 days; P = .87), or in-hospital mortality (15.9% vs 10.8%; P = .4). A significant difference was observed in the duration of antibiotic exposure (3.32 vs 2.62 days; P = .045 days). Conclusion: VPT was not associated with an increased risk of AKI or adverse renal outcomes. Our findings suggest that the use of this antibiotic combination should not be avoided in this patient population. More robust prospective studies are warranted to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Nephrotoxic Risk Associated With Combination Therapy of Vancomycin and Piperacillin-Tazobactam in Critically Ill Patients With Chronic Kidney Disease

Pipkin,

Pope,

Killian

et al. 2024

J Intensive Care Med

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36th International Symposium on Intensive Care and Emergency Medicine

Bateman¹,

Sharpe²,

Jagger³

et al. 2016

Crit Care

312

110

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Positive fluid balance is an independent risk factor for acute kidney injury in critically ill patients: results of a prospective, cross-sectional study

Cited by 2 publications

References 0 publications

Nephrotoxic Risk Associated With Combination Therapy of Vancomycin and Piperacillin-Tazobactam in Critically Ill Patients With Chronic Kidney Disease

Nephrotoxic Risk Associated With Combination Therapy of Vancomycin and Piperacillin-Tazobactam in Critically Ill Patients With Chronic Kidney Disease

36th International Symposium on Intensive Care and Emergency Medicine

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