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Crit Care Med. Author manuscript; available in PMC 2017 October 01. Published in final edited form as: Crit Care Med. 2016 October ; 44(10): 1891–1900. doi:10.1097/CCM.0000000000001835.

Cumulative Fluid Balance and Mortality in Septic Patients with or without Acute Kidney Injury and Chronic Kidney Disease Javier A. Neyra, MD1, Xilong Li, PhD, MS2, Fabrizio Canepa-Escaro, MD3, Beverley AdamsHuet, MS2, Robert D. Toto, MD1, Jerry Yee, MD4, and S. Susan Hedayati, MD, MHSc1,5 for the Acute Kidney Injury in Critical Illness Study Group 1Division

of Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

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2Department

of Clinical Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center, Dallas, Texas, USA

3Department 4Division

of Internal Medicine, Asante Health System, Grants Pass, Oregon, USA

of Nephrology and Hypertension, Henry Ford Hospital, Detroit, Michigan, USA

5Renal

Section, Medical Service, Veterans Affairs North Texas Health Care System, Dallas, Texas, USA

Abstract

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Objective—Incident acute kidney injury (AKI) and prevalent chronic kidney disease (CKD) are commonly encountered in septic patients. We examined the differential effect of AKI and CKD on the association between cumulative fluid balance (CFB) and hospital mortality in critically ill septic patients. Design—Retrospective cohort study. Setting—Urban academic medical center ICU. Patients—ICU adult patients with severe sepsis or septic shock and serum creatinine measured within 3 months prior to and 72 h of ICU admission. Patients with estimated glomerular filtration rate