Association between postoperative fluid balance and acute kidney injury in patients after cardiac surgery: A retrospective cohort study

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Purpose:The present study aims to explore appropriate postoperative fluid management in patients after cardiac surgery.Materials and methods:Data were extracted from an online database. Associations between fluid balance (FB), fluid intake and mortality were investigated.Results:Compared to zero FB (level 3), more negative FB (level 1, odds ratio (OR): 0.938, 95% CI: 0.631–1.394; level 2, OR: 0.921, 95% CI: 0.709–1.196) could not further decrease AKI incidence while positive FB was associated with higher AKI incidence (level 4, OR: 1.272, 95% CI: 1.028–1.573; level 5, OR: 2.042, 95% CI: 1.652–2.524). Both limited (level 1, OR: 1.354, 95% CI: 1.065–1.699) and increased postoperative fluid intake (level 3, OR: 1.127, 95% CI: 0.890–1.430; to level 5, OR: 1.405, 95% CI: 1.105–1.786) were associated with increased AKI incidence, compared to level 2. Multivariable logistic models using linear spline function showed a similar pattern.Conclusions:Compared to zero FB, postoperative positive FB was associated with higher AKI incidence. Yet, the association between negative FB and AKI was insignificant. A “U”-shape association between postoperative fluid intake and AKI was detected.HighlightsAchieving more negative FB was not associated with lower AKI incidence.Positive postoperative FB was associated higher AKI incidence.A “U” shaped association was detected between postoperative fluid intake and AKI.

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