Balanced Crystalloids versus Saline in Critically Ill Adults with Hyperkalemia or Acute Kidney Injury: Secondary Analysis of a Clinical Trial

Abstract

Definition of abbreviations: AKI 5 acute kidney injury; CKD 5 chronic kidney disease (stage 3 or greater); N/A 5 not applicable; RRT 5 renal replacement therapy.Continuous data are presented as median (25th percentile-75th percentile) unless otherwise noted.*Chronic kidney disease stage 3 or greater is defined as a glomerular filtration rate of ,60 ml/min per 1.73 m 2 as calculated by the Chronic Kidney Disease Epidemiology Collaboration equation using the patient's baseline creatinine concentration.† Patients who had received RRT before admission were excluded from the cohort of patients with AKI on admission.‡ Patients who had received RRT before ICU admission were excluded from calculations of AKI and creatinine at baseline and were ineligible to meet the clinical outcome criteria for new RRT or new AKI developing after enrollment.§ Stage 2 or greater AKI is defined using the Kidney Disease Improving Global Outcomes creatinine criteria (7) as any creatinine value between ICU admission and discharge or 30 days that is 1) increased at least 0.3 mg/dl from a preceding post-ICU admission value and 2) at least 200% of the baseline value, at least 200% of a preceding post-ICU admission value, or at least 4.0 mg/dl; or new receipt of RRT.jj The University Health Consortium index is a severity-of-illness score calculated using variables available on hospital admission to provide an estimation of mortality from 0% to 100%.¶ Cumulative volume of fluid ordered from ICU admission through Day 30 includes fluid ordered both in the ICU and after transfer out of the ICU.Balanced crystalloid includes lactated Ringer's and Plasma-Lyte A. **Data on potassium-lowering therapies only available among patients with hyperkalemia on ICU admission.

Topics & Concepts