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Related Experiment Video

Updated: May 10, 2026

Direct Drug Delivery to Kidney via the Renal Artery
11:18

Direct Drug Delivery to Kidney via the Renal Artery

Published on: April 17, 2021

Fluid administration and the kidney.

John R Prowle1, Rinaldo Bellomo

  • 1Adult Critical Care Unit and Department of Renal Medicine and Transplantation, The Royal London Hospital, Barts Health NHS Trust, London, UK.

Current Opinion in Critical Care
|June 20, 2013
PubMed
Summary
This summary is machine-generated.

Fluid administration in critically ill patients requires balancing resuscitation needs with fluid overload risks. Avoid hydroxyethyl starches and potentially saline in patients with acute kidney injury (AKI).

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Area of Science:

  • Critical Care Medicine
  • Nephrology
  • Intravenous Fluid Therapy

Background:

  • Fluid administration is crucial in critical care but its impact on kidney function remains debated.
  • Evidence guiding fluid therapy in patients at risk of acute kidney injury (AKI) is limited.

Purpose of the Study:

  • To review recent studies on fluid administration and kidney function in critically ill patients.
  • To evaluate the risks and benefits of fluid therapy in the context of acute kidney injury (AKI).

Main Methods:

  • Review of recent studies and available information.
  • Analysis of evidence from single-center and large observational studies.
  • Examination of the impact of fluid composition on AKI risk.

Main Results:

  • Limited large trials exist to guide fluid therapy for AKI risk.
  • Fluid resuscitation benefits must be weighed against fluid overload harm.
  • Hydroxyethyl starches and possibly saline solutions are associated with increased AKI risk.

Conclusions:

  • Clinicians must balance cardiac output resuscitation with avoiding fluid overload.
  • Protocolized resuscitation to hemodynamic goals may aid in managing conflicting objectives.
  • Avoid starch and consider avoiding saline in critically ill patients with or at risk of AKI.