title: The role of fluid overload in the prediction of outcome in acute kidney injury.
abstract: Our understanding of the epidemiology and the impact of acute kidney injury (AKI) and fluid overload on outcomes has improved significantly over the past several decades. Fluid overload occurs commonly in critically ill children with and without associated AKI. Researchers in pediatric AKI have been at the forefront of describing the impact of fluid overload on outcomes in a variety of populations. A full understanding of this topic is important as fluid overload represents a potentially modifiable risk factor and a target for intervention. In this state-of-the-art review, we comprehensively describe the definition of fluid overload, the impact of fluid overload on kidney function, the impact of fluid overload on the diagnosis of AKI, the association of fluid overload with outcomes, the targeted therapy of fluid overload, and the impact of the timing of renal replacement therapy on outcomes.
authors.affiliation: Division of Nephrology, Department of Pediatrics & Communicable Diseases, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA. dselewsk@med.umich.edu.
authors.forename: David T
authors.initials: DT
authors.lastname: Selewski
authors.affiliation: Center for Acute Care Nephrology, Cincinnati Children's Hospital and Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA.
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Goldstein
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D017063:Outcome Assessment, Health Care; D017582:Renal Replacement Therapy / Q000379:methods*; D012307:Risk Factors; D014883:Water-Electrolyte Imbalance / Q000150:complications* / Q000628:therapy
keywords: Acute kidney injury; Continuous renal replacement therapy; Fluid overload; Pediatric; Renal replacement therapy