Normal Saline Versus Balanced Crystalloid Solutions for Kidney Transplantation.

Abstract:

INTRODUCTION:The ideal crystalloid solution to be used during the perioperative period in patients undergoing kidney transplantation remains unclear. Normal saline (NS), the intravenous fluid commonly using during the perioperative period, contains a high chloride content, which may be associated with hyperchloremic metabolic acidosis and acute kidney injury. Balanced crystalloid (BC) solutions have a lower chloride content. The purpose of the study was to determine if a BC solution prevents the incidence of hyperchloremia and hyperkalemia during renal transplantation. METHODS:NS and BC given during kidney transplantation are compared. The primary outcome was hyperchloremia and hyperkalemia within 24 hours after surgery. Secondary outcomes were levels of serum creatinine at preoperative and within 5 days after transplantation, the incidence of acute rejection episodes, graft failure, length of stay at hospital, and mortality. RESULTS:A total of 60 patients were included in the study (30 in the BC group and 30 in the NS group). The mean postoperative chloride was 103.0 mmol/L (95% CI, 101-105) in the NS group and 100 mmol/L (95% CI, 98-102) in the BC group (P < .05). There were no significant differences in demographic characteristics, serum creatinine values within 5 days, short-term outcomes, and graft survival rates at 28 days postoperatively between groups (P > .05). CONCLUSIONS:Our results suggest that a moderate volume (approximately 1500.0 mL) of NS infusion causes hyperchloremia rather than adverse clinical outcomes. A moderate amount of NS infusion can be used safely during uncomplicated living-donor kidney transplantations.

journal_name

Transplant Proc

authors

Arslantas R,Dogu Z,Cevik BE

doi

10.1016/j.transproceed.2019.03.050

subject

Has Abstract

pub_date

2019-09-01 00:00:00

pages

2262-2264

issue

7

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)31764-0

journal_volume

51

pub_type

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