الفهرس 
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Abstract
Fluid management in critical illness has undergone extensive reevaluation in the past decade. Since a significant percentage of critically ill patients develop acute kidney injury (AKI), optimal fluid management is even more paramount to prevent the ill effects of either underhydration or overhydration. AKI and fluids are closely linked through oliguria, which is a marker of the former and a trigger for administration of the latter. Recent progress in this field has challenged the physiological and clinical rational of using oliguria as a trigger for the administration of fluid and brought attention to the delicate balance between benefits and harms of different aspects of fluid management in critically ill patients, in particular those with AKI. This essay aims to address various aspects of fluid management in AKI outlining physiological aspects, the effects of crystalloids and colloids on kidney function and the effect of various resuscitation and de-resuscitation strategies on the course and outcome of AKI. In conclusion, optimal fluid management has great beneficial potential in critically ill patients at risk of AKI and those with established AKI. On the other hand, there is an imminent risk of harming these patients by the choice, timing, rate and volume of IV fluids. There is an urgent need for better technologies to assess blood volume and hydration status of our patients beyond fluid responsiveness. Bioelectrical impedance vector analysis (BIVA) may hold some promise. Nevertheless, further large-scale studies are still needed to assess the role of the fluid management and BIVA on AKI.