↓ Skip to main content

Fluid balance, intradialytic hypotension, and outcomes in critically ill patients undergoing renal replacement therapy: a cohort study

Overview of attention for article published in Critical Care, November 2014
Altmetric Badge

About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (64th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

twitter
4 tweeters

Citations

dimensions_citation
61 Dimensions

Readers on

mendeley
78 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Fluid balance, intradialytic hypotension, and outcomes in critically ill patients undergoing renal replacement therapy: a cohort study
Published in
Critical Care, November 2014
DOI 10.1186/s13054-014-0624-8
Pubmed ID
Authors

Jonathan A Silversides, Ruxandra Pinto, Rottem Kuint, Ron Wald, Michelle A Hladunewich, Stephen E Lapinsky, Neill KJ Adhikari

Abstract

IntroductionIn this cohort study, we explored the relationship between fluid balance, intradialytic hypotension and outcomes in critically ill patients with acute kidney injury (AKI) who received renal replacement therapy (RRT).MethodsWe analysed prospectively collected registry data on patients older than 16 years who received RRT for at least 2 days in an intensive care unit at two university-affiliated hospitals. We used multivariable logistic regression to determine the relationship between mean daily fluid balance and intradialytic hypotension, both over 7 days following RRT initiation, and the outcomes of hospital mortality and RRT dependence in survivors.ResultsIn total, 492 patients were included (299 male (60.8%), mean (standard deviation (SD)) age 62.9 (16.3) years); 251 (51.0%) died in hospital. Independent risk factors for mortality were mean daily fluid balance (odds ratio (OR) 1.36 per 1000 mL positive (95% confidence interval (CI) 1.18 to 1.57), intradialytic hypotension (OR 1.14 per 10% increase in days with intradialytic hypotension (95%CI 1.06 to 1.23)), age (OR 1.15 per 5 year increase (95%CI 1.07 to 1.25)), maximum Sequential Organ Failure Assessment score on days 1 to 7 (OR 1.21 (95%CI 1.13 to 1.29)), and Charlson comorbidity index (OR 1.28 (95%CI 1.14 to 1.44)); higher baseline creatinine (OR 0.98 per 10 ¿mol/L (95%CI 0.97 to 0.996)) was associated with lower risk of death. Of 241 hospital survivors, 61 (25.3%) were RRT dependent at discharge. The only independent risk factor for RRT dependence was pre-existing heart failure (OR 3.13 (95% CI 1.46 to 6.74)). Neither mean daily fluid balance nor intradialytic hypotension was associated with RRT dependence in survivors. Associations between these exposures and mortality were similar in sensitivity analyses accounting for immortal time bias and dichotomising mean daily fluid balance as positive or negative. In the subgroup of patients with data on pre-RRT fluid balance, fluid overload at RRT initiation did not modify the association of mean daily fluid balance with mortality.ConclusionsIn this cohort of patients with AKI requiring RRT, a more positive mean daily fluid balance and intradialytic hypotension were associated with hospital mortality but not with RRT dependence at hospital discharge in survivors.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 78 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 1 1%
Brazil 1 1%
Unknown 76 97%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 17%
Student > Master 12 15%
Student > Ph. D. Student 10 13%
Professor > Associate Professor 9 12%
Student > Postgraduate 8 10%
Other 20 26%
Unknown 6 8%
Readers by discipline Count As %
Medicine and Dentistry 55 71%
Nursing and Health Professions 5 6%
Engineering 2 3%
Psychology 2 3%
Pharmacology, Toxicology and Pharmaceutical Science 2 3%
Other 3 4%
Unknown 9 12%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 December 2014.
All research outputs
#5,850,179
of 11,252,870 outputs
Outputs from Critical Care
#2,418
of 3,703 outputs
Outputs of similar age
#85,442
of 244,009 outputs
Outputs of similar age from Critical Care
#106
of 173 outputs
Altmetric has tracked 11,252,870 research outputs across all sources so far. This one is in the 47th percentile – i.e., 47% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,703 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.0. This one is in the 33rd percentile – i.e., 33% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 244,009 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.
We're also able to compare this research output to 173 others from the same source and published within six weeks on either side of this one. This one is in the 36th percentile – i.e., 36% of its contemporaries scored the same or lower than it.