Intravenous fluid therapy in accordance with kidney injury risk: when to prescribe what volume of which solution

Acute kidney injury (AKI) is common in hospitalized patients while common risk factors for the development of AKI include postoperative settings, patients with baseline chronic kidney disease (CKD) or congestive heart failure. Intravenous (IV) fluid therapy is a crucial component of care for prevention and treatment of AKI. In this narrative review, we update the approach to IV fluid therapy in hospitalized patients including the timing of fluid prescription, and the choice of fluid type, amount and infusion rate along with the potential adverse effects of various crystalloid and colloid solutions, addressing specifically their use in patients with acute kidney disease, CKD or heart failure, and their potential impact on the risk of hospital-acquired AKI.

Automated summary

Acute kidney injury (AKI) is a common condition in hospitalized patients, with risk factors including postoperative settings, baseline chronic kidney disease (CKD), and congestive heart failure. Intravenous (IV) fluid therapy is an essential component of AKI prevention and treatment. This review discusses the timing, fluid type, amount, and infusion rate of IV fluid therapy in hospitalized patients, as well as the potential adverse effects of different crystalloid and colloid solutions, specifically in patients with AKI, CKD, or heart failure, and their impact on the risk of hospital-acquired AKI.