Fluid Overload

Fluid overload is harder to prevent than dehydration because it is often driven by underlying pathology rather than modifiable behaviour. Fluid overload is an abnormal fluid state in which excess body fluid is not excreted efficiently, and can accumulate in peripheral tissues, lungs, or abdomen. Heart failure is commonly associated with fluid overload because it reduces kidney perfusion and disrupts the renin-angiotensin-aldosterone and anti-diuretic hormone systems. Healthy kidneys can usually excrete excess fluid unless volume is excessive or disease disrupts excretion, but chronic kidney disease and acute kidney injury impair fluid removal. Impaired oncotic pressure, such as from low albumin or sepsis, can prevent interstitial and intracellular fluid from returning to the vascular compartment, making excess fluid harder to remove. Treatment of fluid overload typically focuses on diuretics, sometimes combined with other medicines, to promote diuresis.