Fluid Balance During Early Hours of Acute Kidney Injury in Critically Ill Patients
Overview
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Assiut University
- Enrollment
- 120
- Primary Endpoint
- Incidence of Acute Kidney Injury (AKI)
Overview
Brief Summary
This prospective observational cohort study evaluates if fluid balance in the first 48 hours of ICU admission is linked to acute kidney injury (AKI) in critically ill adults. Patients without AKI at entry will have fluids tracked hourly via charts, weights, and labs to assess AKI risk by KDIGO criteria within 7 days. Findings may guide better fluid management to lower AKI rates.
Detailed Description
This prospective observational cohort study at Assiut University Hospital ICU investigates the association between fluid balance in the first 48 hours of admission and acute kidney injury (AKI) development. Critically ill adults (≥18 years) without AKI at baseline will undergo routine monitoring: hourly fluid intake/output (IV fluids, blood products, urine, drains, insensible losses), daily weights, serial labs (SCr, BUN, electrolytes, albumin, CRP), and clinical/hemodynamic assessments. AKI is defined/staged by KDIGO criteria within 7 days. Sample size is 120 (Epi-Info calculated, 38.4% expected AKI incidence). Data analysis will examine if positive/negative balances predict AKI incidence, severity, RRT need, ICU stay, and 28-day mortality, using AKI-FB risk score. No interventions; standard care only.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adults aged 18 years or older admitted to the ICU.
- •Patients with no AKI at ICU admission.
- •AKI secondary to (prerenal cause-renal and post renal with manifestation of hypovolemia)-postoperative settings-On top of CKD up to Stage 111b-Compansated heart failure with indication of fluid therapy
Exclusion Criteria
- •Patients with pre-existing end-stage renal disease requiring dialysis.
- •Patients with known chronic kidney disease stage 4 or higher.
- •ICU readmissions during the same hospitalization.
- •Patients who received renal replacement therapy before ICU admission
- •Patients with AKI with manifestation of over load as pulmonary edema- pulmonary embolism-Acute decompensated heart failure
Outcomes
Primary Outcomes
Incidence of Acute Kidney Injury (AKI)
Time Frame: Within 7 days after ICU admission
Development of AKI defined by KDIGO criteria (increase in serum creatinine by ≥0.3 mg/dL within 48 hours or ≥1.5 times baseline within 7 days, or urine output \<0.5 mL/kg/h for 6 hours).
Secondary Outcomes
- AKI Stage by KDIGO Criteria(Within 7 days after ICU admission)
Investigators
Engy Bassam Gayel Sayed
Resident at Internal Medicine Department, Assiut University
Assiut University