title: Fluid balance and chloride load in the first 24h of ICU admission and its relation with renal replacement therapies through a multicentre, retrospective, case-control study paired by APACHE-II.
abstract: OBJECTIVE
  To analyse the association between water balance during the first 24h of admission to ICU and the variables related to chloride levels (chloride loading, type of fluid administered, hyperchloraemia), with the development of acute kidney injury renal replacement therapy (AKI-RRT) during patients' admission to ICU.
  
  
  METHODS
  Multicentre case-control study. Hospital-based, national, carried out in 6 ICUs. Cases were patients older than 18 years who developed an AKI-RRT. Controls were patients older than 18 years admitted to the same institutions during the study period, who did not develop AKI-RRT during ICU admission. Pairing was done by APACHE-II. An analysis of unconditional logistic regression adjusted for age, sex, APACHE-II and water balance (in evaluating the type of fluid).
  
  
  RESULTS
  We analysed the variables of 430 patients: 215 cases and 215 controls. An increase of 10% of the possibility of developing AKI-RRT per 500ml of positive water balance was evident (OR: 1.09 [95% CI: 1.05 to 1.14]; P<.001). The study of mean values of chloride load administered did not show differences between the group of cases and controls (299.35±254.91 vs. 301.67±234.63; P=.92).
  
  
  CONCLUSIONS
  The water balance in the first 24h of ICU admission relates to the development of IRA-TRR, regardless of chloraemia.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: e409@humv.es.
authors.forename: A
authors.initials: A
authors.lastname: González-Castro
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors.forename: M
authors.initials: M
authors.lastname: Ortiz-Lasa
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cabueñes, Gijón, España.
authors.forename: O
authors.initials: O
authors.lastname: Leizaola
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario de Cabueñes, Gijón, España.
authors.forename: E
authors.initials: E
authors.lastname: Salgado
authors.affiliation: Servicio de Medicina Intensiva, Hospital Germans Trias i Pujol, Badalona, España.
authors.forename: T
authors.initials: T
authors.lastname: Irriguible
authors.affiliation: Servicio de Medicina Intensiva, Hospital Germans Trias i Pujol, Badalona, España.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez-Satorra
authors.affiliation: Servicio de Medicina Intensiva, Hospital Moisés Broggi, Sant Joan Despí, España.
authors.forename: C
authors.initials: C
authors.lastname: Lomas-Fernández
authors.affiliation: Servicio de Medicina Intensiva, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España.
authors.forename: P
authors.initials: P
authors.lastname: Barral-Segade
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Araba, Vitoria, España.
authors.forename: M
authors.initials: M
authors.lastname: Cordero-Vallejo
authors.affiliation: Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors.forename: E
authors.initials: E
authors.lastname: Rodrigo-Calabia
authors.affiliation: Departamento de Medicina Preventiva y Salud Pública, Universidad de Cantabria, Santander, España.
authors.forename: T
authors.initials: T
authors.lastname: Dierssen-Sotos
mesh_terms: D018806:APACHE; D058186:Acute Kidney Injury / Q000378:metabolism* / Q000628:therapy*; D000368:Aged; D016022:Case-Control Studies; D002712:Chlorides / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D013997:Time Factors; D014882:Water-Electrolyte Balance
chemical_list: D002712:Chlorides
keywords: Acute kidney failure; Balance hídrico; Chloraemia; Cloremia; Fluid balance; Fluidos; Fluids; Insuficiencia renal; Reanimación; Renal replacement therapy; Resuscitation; Técnicas de reemplazo renal