{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:19:03Z","timestamp":1773832743549,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":294,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Critical Care Research and Practice"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Chloride is the most abundant extracellular anion; however, abnormalities of serum chloride (dyschloremia) are often overlooked. This study aimed to study the association of dyschloremia with AKI and major adverse kidney events at Day 30 (MAKE30) in critically ill patients with sepsis.<\/jats:p><jats:p><jats:bold>Materials and Methods:<\/jats:bold> This prospective single\u2010center cohort study included adult patients with sepsis admitted in a tertiary care hospital in India. Patients with advanced chronic kidney disease, requiring dialysis at admission, or with hospital stay of less than 72\u2009h were excluded. Hyperchloremia and hypochloremia were defined as chloride levels of &gt;\u2009110\u2009mEq\/L and &lt;\u200995\u2009mEq\/L, respectively. The primary outcome measure was MAKE30\u2014a composite of death, need for dialysis, or sustained loss of kidney function at Day 30.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> In a cohort of 400 patients with a mean age of 60 (\u00b115) years, AKI was seen in 301 (75.2%) and MAKE30 in 171 (42.8%). Hyperchloremia and hypochloremia were seen in 19.3% (<jats:italic>n<\/jats:italic>\u2009=\u200977) and 32.3% (<jats:italic>n<\/jats:italic>\u2009=\u2009129), respectively, in the first 72\u2009h of ICU stay. Hypochloremia, but not hyperchloremia, was independently associated with both MAKE30 (OR: 2.56, 95% CI: 1.13\u20135.79; <jats:italic>p<\/jats:italic> = 0.024) and new\u2010onset or worsening AKI (OR: 2.52, 95% CI: 1.17\u20135.41; <jats:italic>p<\/jats:italic> = 0.019). There was no association between hyperchloremia and either MAKE30 (OR: 1.07, 95% CI: 0.43\u20132.69; <jats:italic>p<\/jats:italic> = 0.882) or new\u2010onset\/worsening AKI (OR: 0.89, 95% CI: 0.38\u20132.09; <jats:italic>p<\/jats:italic> = 0.781).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Hypochloremia, but not hyperchloremia, was associated with MAKE30 in this cohort of critically ill patients with sepsis.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> Clinical Trial Registry identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/CTRI\/\/2022\/02\/040519\">CTRI\/\/2022\/02\/040519<\/jats:ext-link><\/jats:p>","DOI":"10.1155\/2024\/8848405","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T13:06:47Z","timestamp":1729516007000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dyschloremia and Renal Outcomes in Critically Ill Patients With Sepsis: A Prospective Cohort Study"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1780-2022","authenticated-orcid":false,"given":"Saurabh M.","family":"Thanekar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5255-6148","authenticated-orcid":false,"given":"Vishal","family":"Shanbhag","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5980-7197","authenticated-orcid":false,"given":"Attur Ravindra","family":"Prabhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1016-8280","authenticated-orcid":false,"given":"Shankar Prasad","family":"Nagaraju","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6152-7493","authenticated-orcid":false,"given":"Dharshan","family":"Rangaswamy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7405-4106","authenticated-orcid":false,"given":"Srinivas Vinayak","family":"Shenoy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1814-2360","authenticated-orcid":false,"given":"Mohan Varadarayanahalli","family":"Bhojaraja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5061-739X","authenticated-orcid":false,"given":"Indu Ramachandra","family":"Rao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/479730"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199602000-00003"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.7.813"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0487-8"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-021-06454-7"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-017-0750-z"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-018-0388-4"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-016-0311-7"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000001161"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318293d81e"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1172\/jci110820"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.1979.237.6.f441"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1976.sp011348"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/bf00586003"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-019-02165-6"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-019-0753-3"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.03.081"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.cj-17-0938"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.007"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2018.04.028"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0287"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/ccm.0000000000002255"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01709751"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc10497"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.12791211"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0160322"},{"key":"e_1_2_10_28_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.11401.1"},{"key":"e_1_2_10_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/aas.12694"},{"key":"e_1_2_10_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-016-0528-z"},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-022-01040-6"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273283"},{"key":"e_1_2_10_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-76798-5"}],"container-title":["Critical Care Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2024\/8848405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T13:06:50Z","timestamp":1729516010000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2024\/8848405"}},"subtitle":["Dyschloremia and Renal Outcomes in Sepsis"],"editor":[{"given":"Alessia","family":"Mattei","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1155\/2024\/8848405"],"URL":"https:\/\/doi.org\/10.1155\/2024\/8848405","archive":["Portico"],"relation":{},"ISSN":["2090-1305","2090-1313"],"issn-type":[{"value":"2090-1305","type":"print"},{"value":"2090-1313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2024-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8848405"}}