Fluid overload at the start of renal replacement therapy (RRT) for patients with acute kidney injury (AKI) is associated with worse long-term survival, investigators reported at the European Renal Association-European Dialysis and Transplant Association 53rd Congress in Vienna.

In a retrospective cohort study, Masataka Hasegawa, MD, and collaborators at St. Luke’s International Hospital in Tokyo, Japan, found that patients with fluid overload at RRT initiation had a 2-fold increased risk of all-cause mortality compared with those who did not have fluid overload, after adjusting for sex, estimated glomerular filtration rate at admission, Charlson co-morbidity index, and other confounders. The patients with fluid overload also had a 2-fold increased risk of 90-day all-cause mortality.

The study included 211 adult AKI patients who required RRT from January 2004 to December 2014. Patients were followed up to December 2015. Of the 211 patients, 137 (62%) died during a median 1,279 days of follow-up.

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The researchers defined fluid overload at RRT initiation as a greater than 10% increase in body weight compared with baseline.

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