Related Experiment Video
Updated: Mar 6, 2026
Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury
Published on: February 15, 2022
Fluid overload and kidney failure in children with severe sepsis and septic shock: A cohort study
Omar E Naveda Romero1, Andrea F Naveda Meléndez2
1Hospital Universitario de Pediatría "Dr. Agustín Zubillaga", Barquisimeto, Estado Lara, Venezuela. omarnavedamd@yahoo.com.
Insights
Fluid overload in children with severe sepsis increases the risk of kidney failure and mortality. Prompt management of fluid balance is crucial for improving outcomes in pediatric sepsis patients.
Area of Science:
- Pediatric critical care medicine
- Nephrology
- Infectious diseases
Background:
- Fluid overload is a potential complication in pediatric sepsis management.
- Aggressive fluid administration may lead to adverse renal outcomes and increased mortality in children.
Purpose of the Study:
- To investigate the association between fluid overload and kidney failure in pediatric patients with severe sepsis and septic shock.
- To identify risk factors for kidney failure in this vulnerable population.
Main Methods:
- Prospective cohort study conducted in a pediatric intensive care unit.
- Analysis of 149 children with severe sepsis or septic shock.
- Binary logistic regression and Kaplan-Meier analysis were used.
Main Results:
- 30.2% of patients experienced fluid overload; 16.1% developed kidney failure.
- Fluid overload (OR: 1.5) and shock >2 days (OR: 1.7) were independent predictors of kidney failure.
- Increased mortality risk was observed in children with kidney failure and fluid overload (p=0.019).
Conclusions:
- Fluid overload and prolonged shock are significant risk factors for kidney failure in critically ill children with sepsis.
- Clinical monitoring and management of fluid balance are essential in pediatric sepsis care.
- Early identification and intervention for fluid overload may mitigate kidney injury and improve survival rates.
Introduction:
In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality.
Abstract:
Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septic shock.
Population And Methods:
This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría “Dr. Agustín Zubillaga” (Barquisimeto, Lara State, Venezuela), between March 2013 and May 2016, in children with severe sepsis or septic shock.
Results:
One hundred and forty-nine patients were included in the analysis. Sepsis predominated in 59.7% of cases; patients' average age was 6.4 ± 3.3 years old, their average weight was 17.8 ± 3.6 kg, 30.2% had fluid overload, and overall mortality was 25.5%. Kidney failure occurred in 16.1% of cases. A binary logistic regression model was used to identify fluid overload (odds ratio [OR]: 1.5; 95% confidence interval [CI]: 1.2-4.9, p = 0.028) and shock for more than 2 days (OR: 1.7; 95% CI: 1.3-6.3, p = 0.039) as independent predictors of kidney failure. In addition, a significant increase in the risk of mortality among children with kidney failure and fluid overload was observed as per the Kaplan-Meier method (p= 0.019).
Conclusion:
Fluid overload and shock for more than 2 days increase the risk for kidney failure in critically ill children with severe sepsis and septic shock.
Related Concept Videos
01:20Acute Kidney Injury V: Interprofessional Care
01:29Acute Kidney Injury II: Pathophysiology
01:22Acute Kidney Injury VI: Nursing Management
01:29Acute Kidney Injury III: Clinical Manifestations
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:22Acute Kidney Injury I: Introduction