Fluid overload in acute kidney injury

A central objective in the management of acute kidney injury is the restoration and maintenance of adequate systemic and renal perfusion, often requiring the parallel administration of fluids and vasoactive drugs. However, hypovolaemia and fluid overload may both predispose the patient to complications and poor outcomes. Therefore, body weight and daily fluid intake/output should be recorded, patients should continuously be assessed for clinical signs of under- or over-hydration, and adequate monitoring of haemodynamic parameters should be performed. Together these parameters constitute the basis for individualized fluid therapy that needs to be initiated promptly and should be re-evaluated at least on a daily basis.