Normal saline versus lower-chloride solutions for kidney transplantation.

Abstract:

BACKGROUND:The ideal intravenous fluid for kidney transplantation has not been defined, despite the common use of normal saline during the peri-operative period. The high chloride content of normal saline is associated with an increased risk of hyperchloraemic metabolic acidosis, which may in turn increase the risk of hyperkalaemia and delayed graft function. Balanced electrolyte solutions have a lower chloride content which may decrease this risk and avoid the need for dialysis due to hyperkalaemia in the immediate post-transplant period. Randomised controlled trials (RCTs) addressing this issue have used biochemical outcomes to compare fluids and have been underpowered to address patient-centred outcomes such as delayed graft function. OBJECTIVES:To examine the effect of lower-chloride solutions versus normal saline on delayed graft function, hyperkalaemia and acid-base status in kidney transplant recipients. SEARCH METHODS:We searched the Cochrane Kidney and Transplant's Specialised Register to 26 November 2015 through contact with the Information Specialist using search terms relevant to this review. SELECTION CRITERIA:RCTs of kidney transplant recipients that compared peri-operative intravenous lower-chloride solutions to normal saline were included. DATA COLLECTION AND ANALYSIS:Two independent investigators assessed studies for eligibility and risk of bias. Data from individual studies were extracted using standardised forms and pooled according to a published protocol. Summary estimates of effect were obtained using a random-effects model, and results were expressed as risk ratios (RR) and their 95% confidence intervals (CI) for dichotomous outcomes, and mean difference (MD) and 95% CI for continuous outcomes. MAIN RESULTS:Six studies (477 participants) were included in the review. All participants were adult kidney transplant recipients and 70% of participants underwent live-donor kidney transplantation. The overall risk of bias was low for selection bias and unclear for remaining domains. There was no difference in the risk of delayed graft function (3 studies, 298 participants: RR 1.03, 95% CI 0.62 to 1.70) or hyperkalaemia (2 studies, 199 participants: RR 0.48, 95% CI 0.04 to 6.10) for participants who received balanced electrolyte solutions compared to normal saline. Intraoperative balanced electrolyte solutions compared to normal saline were associated with higher blood pH (3 studies, 193 participants: MD 0.07, 95% CI 0.05 to 0.09), higher serum bicarbonate (3 studies, 215 participants: MD 3.02 mEq/L, 95% CI 2.00 to 4.05) and lower serum chloride (3 studies, 215 participants: MD -9.93 mmol/L, 95% CI -19.96 to 0.11). There were four cases of graft loss in the normal saline group and one in the balanced electrolyte solution group, and four cases of acute rejection in the normal saline group compared to two cases in the balanced electrolyte solution group. AUTHORS' CONCLUSIONS:Balanced electrolyte solutions are associated with less hyperchloraemic metabolic acidosis compared to normal saline, however it remains uncertain whether lower-chloride solutions lead to improved graft outcomes compared to normal saline.

authors

Wan S,Roberts MA,Mount P

doi

10.1002/14651858.CD010741.pub2

subject

Has Abstract

pub_date

2016-08-09 00:00:00

pages

CD010741

issue

8

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Elective delivery of women with a twin pregnancy from 37 weeks' gestation.

    abstract:BACKGROUND:The optimal timing of birth for women with an otherwise uncomplicated twin pregnancy at term is uncertain, with clinical support for both elective delivery at 37 weeks, as well as expectant management (awaiting the spontaneous onset of labour). OBJECTIVES:To assess a policy of elective delivery from 37 week...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003582

    authors: Dodd JM,Crowther CA

    更新日期:2003-01-01 00:00:00

  • Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting.

    abstract:BACKGROUND:There have been recent advances in chemotherapy-induced nausea and vomiting using 5-HT(3) inhibitors and dexamethasone. However, many still experience these symptoms, and expert panels encourage additional methods to reduce these symptoms. OBJECTIVES:The objective was to assess the effectiveness of acupunct...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002285.pub2

    authors: Ezzo JM,Richardson MA,Vickers A,Allen C,Dibble SL,Issell BF,Lao L,Pearl M,Ramirez G,Roscoe J,Shen J,Shivnan JC,Streitberger K,Treish I,Zhang G

    更新日期:2006-04-19 00:00:00

  • Low molecular weight heparins versus unfractionated heparin for acute coronary syndromes.

    abstract:BACKGROUND:Acute coronary syndromes (ACS) are an important source of morbidity and mortality. Despite weak evidence for the use of unfractionated heparin (UFH) for acute coronary syndromes it is considered an accepted treatment for unstable angina and non-ST segment elevation myocardial infarction (MI). However, eviden...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002132

    authors: Magee KD,Sevcik W,Moher D,Rowe BH

    更新日期:2003-01-01 00:00:00

  • Psychosocial interventions for preventing and treating depression in dialysis patients.

    abstract:BACKGROUND:People with end-stage kidney disease (ESKD) treated with dialysis are frequently affected by major depression. Dialysis patients have prioritised depression as a critically important clinical outcome in nephrology trials. Psychological and social support are potential treatments for depression, although a Co...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD004542.pub3

    authors: Natale P,Palmer SC,Ruospo M,Saglimbene VM,Rabindranath KS,Strippoli GF

    更新日期:2019-12-02 00:00:00

  • Antithrombotic drugs for carotid artery dissection.

    abstract:BACKGROUND:Extracranial internal carotid artery dissection can lead to occlusion of the artery and hence cause an ischaemic stroke. It is the underlying stroke mechanism in approximately 2.5% of all strokes. It is the second leading cause of stroke in patients younger than 45 years of age. Anticoagulants or antiplatele...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000255

    authors: Lyrer P,Engelter S

    更新日期:2003-01-01 00:00:00

  • Magnetic resonance perfusion for differentiating low-grade from high-grade gliomas at first presentation.

    abstract:BACKGROUND:Gliomas are the most common primary brain tumour. They are graded using the WHO classification system, with Grade II-IV astrocytomas, oligodendrogliomas and oligoastrocytomas. Low-grade gliomas (LGGs) are WHO Grade II infiltrative brain tumours that typically appear solid and non-enhancing on magnetic resona...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD011551.pub2

    authors: Abrigo JM,Fountain DM,Provenzale JM,Law EK,Kwong JS,Hart MG,Tam WWS

    更新日期:2018-01-22 00:00:00

  • Single dose intra-articular morphine for pain control after knee arthroscopy.

    abstract:BACKGROUND:Knee arthroscopy is a common procedure and is associated with postoperative pain. Intra-articular (IA) injection of morphine for pain control has been widely studied, but its analgesic effect after knee arthroscopy is uncertain. OBJECTIVES:To evaluate the relative effects on pain relief and adverse events o...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008918.pub2

    authors: Zou Z,An MM,Xie Q,Chen XY,Zhang H,Liu GJ,Shi XY

    更新日期:2016-05-03 00:00:00

  • Antidepressant drugs for narcolepsy.

    abstract:BACKGROUND:Narcolepsy is a disorder of the central nervous system, the main symptoms of which are excessive daytime sleepiness (EDS) and cataplexy (an abrupt and reversible decrease in or loss of muscle tone, affecting the limbs or trunk or both, elicited by emotional stimuli). Narcolepsy has an adverse impact on peopl...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003724.pub3

    authors: Vignatelli L,D'Alessandro R,Candelise L

    更新日期:2008-01-23 00:00:00

  • Treatment for Lambert-Eaton myasthenic syndrome.

    abstract:BACKGROUND:Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disorder of neuromuscular transmission. Treatments attempt to overcome the harmful autoimmune process, or improve residual neuromuscular transmission OBJECTIVES:The objective was to examine the efficacy of treatment in Lambert-Eaton myasthenic syndro...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003279.pub3

    authors: Keogh M,Sedehizadeh S,Maddison P

    更新日期:2011-02-16 00:00:00

  • Medications for increasing milk supply in mothers expressing breastmilk for their preterm hospitalised infants.

    abstract:BACKGROUND:Breastmilk remains the optimal form of enteral nutrition for term and preterm infants until up to six months postnatal age. Mothers of preterm infants who have not established suck feeds must express their breastmilk and often have difficulty in maintaining sufficient volume for their infants' needs (Donath ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005544.pub2

    authors: Donovan TJ,Buchanan K

    更新日期:2012-03-14 00:00:00

  • Band ligation versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children with chronic liver disease or portal vein thrombosis.

    abstract:BACKGROUND:Portal hypertension commonly accompanies advanced liver disease and often gives rise to life-threatening complications, including haemorrhage from oesophageal and gastrointestinal varices. Variceal haemorrhage commonly occurs in children with chronic liver disease or portal vein obstruction. Prevention is th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD010546.pub2

    authors: Gana JC,Cifuentes LI,Gattini D,Villarroel Del Pino LA,Peña A,Torres-Robles R

    更新日期:2019-09-24 00:00:00

  • Glucocorticoid with cyclophosphamide for paraquat-induced lung fibrosis.

    abstract:BACKGROUND:Paraquat is an effective and widely used herbicide but is also a lethal poison. In many developing countries paraquat is widely available and inexpensive, making poisoning prevention difficult. However most of the people who become poisoned from paraquat have taken it as a means of suicide.Standard treatment...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008084.pub2

    authors: Li LR,Sydenham E,Chaudhary B,You C

    更新日期:2010-06-16 00:00:00

  • Interventions for acute auricular haematoma.

    abstract:BACKGROUND:Acute haematoma of the pinna is a condition where a collection of blood forms beneath the perichondrial layer of the pinna. It is usually caused by blunt trauma, and if untreated will ultimately result in a deformity commonly known as 'cauliflower ear' or 'wrestler's ear'. Various treatments are employed to ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004166.pub2

    authors: Jones SE,Mahendran S

    更新日期:2004-01-01 00:00:00

  • Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable).

    abstract:BACKGROUND:In general, surgery is believed to offer the best prospects for cure for early stage non-small cell lung cancer (NSCLC). In spite of the intention to consider all patients with stage I-II disease for surgery, there are those who, although technically operable, either refuse surgery or are considered inoperab...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002935

    authors: Rowell NP,Williams CJ

    更新日期:2001-01-01 00:00:00

  • Methods of milk expression for lactating women.

    abstract:BACKGROUND:Breastfeeding is important, however not all infants can feed at the breast and methods of expressing milk need evaluation. OBJECTIVES:To assess acceptability, effectiveness, safety, effect on milk composition, contamination and costs of methods of milk expression. SEARCH METHODS:We searched the Cochrane Pr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006170.pub5

    authors: Becker GE,Smith HA,Cooney F

    更新日期:2016-09-29 00:00:00

  • Occupational safety and health enforcement tools for preventing occupational diseases and injuries.

    abstract:BACKGROUND:There is uncertainty as to whether and what extent occupational safety and health regulation and legislation enforcement activities, such as inspections, are effective and efficient to improve workers' health and safety. We use the term regulation to refer both to regulation and legislation. OBJECTIVES:To a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010183.pub2

    authors: Mischke C,Verbeek JH,Job J,Morata TC,Alvesalo-Kuusi A,Neuvonen K,Clarke S,Pedlow RI

    更新日期:2013-08-30 00:00:00

  • Therapeutic touch for healing acute wounds.

    abstract:BACKGROUND:Therapeutic Touch (TT) is an alternative therapy that has gained popularity over the past two decades for helping wounds to heal. Practitioners enter a meditative state and pass their hands above the patient's body to find and correct any imbalances in the patient's 'life energy' or chi. Scientific instrumen...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002766.pub4

    authors: O'Mathúna DP

    更新日期:2016-05-03 00:00:00

  • Surgery for cervical radiculopathy or myelopathy.

    abstract:BACKGROUND:Cervical spondylosis causes pain and disability by compressing the spinal cord or roots. Surgery to relieve the compression may reduce the pain and disability, but is associated with a small but definite risk. . OBJECTIVES:To determine whether: 1) surgical treatment of cervical radiculopathy or myelopathy i...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001466.pub3

    authors: Nikolaidis I,Fouyas IP,Sandercock PA,Statham PF

    更新日期:2010-01-20 00:00:00

  • Electroconvulsive therapy for schizophrenia.

    abstract:BACKGROUND:Electroconvulsive therapy (ECT) involves the induction of a seizure (fit) for therapeutic purposes by the administration of a variable frequency electrical stimulus shock via electrodes applied to the scalp. The effects of its use in people with schizophrenia are unclear. OBJECTIVES:To determine whether ele...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000076

    authors: Tharyan P,Adams CE

    更新日期:2002-01-01 00:00:00

  • Pre-discharge "car seat challenge" for preventing morbidity and mortality in preterm infants.

    abstract:BACKGROUND:Physiological monitoring studies indicate that some preterm infants experience episodes of oxygen desaturation, apnoea, or bradycardia when seated in standard car safety seats. The American Academy of Pediatrics recommends that all preterm infants should be assessed for cardiorespiratory stability in their c...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005386.pub2

    authors: Pilley E,McGuire W

    更新日期:2006-01-25 00:00:00

  • Adhesives for bonded molar tubes during fixed brace treatment.

    abstract:BACKGROUND:Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. The success of a fixed appliance depends partly on the metal attachments (brackets and bands) being glued to the teeth so that they do not become detached during treatment. Brackets (metal sq...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008236.pub3

    authors: Millett DT,Mandall NA,Mattick RC,Hickman J,Glenny AM

    更新日期:2017-02-23 00:00:00

  • Steroids for idiopathic sudden sensorineural hearing loss.

    abstract:BACKGROUND:This is an update of a Cochrane review first published in The Cochrane Library in Issue 1, 2006 and previously updated in 2009.Idiopathic sudden sensorineural hearing loss (ISSHL) is a clinical diagnosis characterised by a sudden deafness of cochlear or retrocochlear origin in the absence of a clear precipit...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003998.pub3

    authors: Wei BP,Stathopoulos D,O'Leary S

    更新日期:2013-07-02 00:00:00

  • Pharmacological interventions for treating intrahepatic cholestasis of pregnancy.

    abstract:BACKGROUND:Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that can develop in pregnancy. It occurs when there is a build-up of bile acids in the maternal blood. It has been linked to adverse maternal and fetal/neonatal outcomes. As the pathophysiology is poorly understood, therapies have been largely e...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD000493.pub3

    authors: Walker KF,Chappell LC,Hague WM,Middleton P,Thornton JG

    更新日期:2020-07-27 00:00:00

  • Surgical versus conservative interventions for treating fractures of the middle third of the clavicle.

    abstract:BACKGROUND:Clavicle fractures are common, accounting for 2.6% to 4% of all fractures. Eighty per cent of clavicle fractures are located in the middle third of the clavicle. Although treatment of these fractures is usually non-surgical, displaced clavicle fractures may be considered for surgical treatment because of the...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD009363.pub3

    authors: Lenza M,Buchbinder R,Johnston RV,Ferrari BA,Faloppa F

    更新日期:2019-01-22 00:00:00

  • Antispasmodics for labour.

    abstract:BACKGROUND:Prolonged labour can lead to increased maternal and neonatal mortality and morbidity due to increased risks of maternal exhaustion, postpartum haemorrhage and sepsis, fetal distress and asphyxia and requires early detection and appropriate clinical response. The risks for complications of prolonged labour ar...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009243.pub3

    authors: Rohwer AC,Khondowe O,Young T

    更新日期:2013-06-05 00:00:00

  • Interventions for treating tuberculous pericarditis.

    abstract:BACKGROUND:Tuberculous (TB) pericarditis is becoming more common. The infection can result in fluid around the heart, which can be fatal. OBJECTIVES:To evaluate evidence from trials about the effects of medical and surgical treatments for TB pericarditis on death and life-threatening conditions. SEARCH STRATEGY:The C...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000526

    authors: Mayosi BM,Volmink JA,Commerford PJ

    更新日期:2000-01-01 00:00:00

  • Interventions for helping to turn term breech babies to head first presentation when using external cephalic version.

    abstract:BACKGROUND:Breech presentation is associated with increased complications. Turning a breech baby to head first presentation using external cephalic version (ECV) attempts to reduce the chances of breech presentation at birth so as to avoid the adverse effects of breech vaginal birth or caesarean section. Interventions ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000184.pub4

    authors: Cluver C,Gyte GM,Sinclair M,Dowswell T,Hofmeyr GJ

    更新日期:2015-02-09 00:00:00

  • Interventions for paracetamol (acetaminophen) overdoses.

    abstract:BACKGROUND:Self-poisoning with paracetamol (acetaminophen) is a common cause of hepatotoxicity in the Western World. Interventions for paracetamol poisoning encompass inhibition of absorption, removal from the vascular system, antidotes, and liver transplantation. OBJECTIVES:The objective was to assess the beneficial ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003328

    authors: Brok J,Buckley N,Gluud C

    更新日期:2002-01-01 00:00:00

  • Dietary advice with or without oral nutritional supplements for disease-related malnutrition in adults.

    abstract:BACKGROUND:Disease-related malnutrition has been reported in 10% to 55% of people in hospital and the community. Dietary advice encouraging the use of energy- and nutrient-rich foods rather than oral nutritional supplements has been suggested as the initial approach for managing disease-related malnutrition. OBJECTIVE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD002008.pub4

    authors: Baldwin C,Weekes CE

    更新日期:2011-09-07 00:00:00

  • Perioperative beta-blockers for preventing surgery-related mortality and morbidity.

    abstract:BACKGROUND:Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES:The objective of this review was t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004476.pub3

    authors: Blessberger H,Kammler J,Domanovits H,Schlager O,Wildner B,Azar D,Schillinger M,Wiesbauer F,Steinwender C

    更新日期:2018-03-13 00:00:00