Effects of normal saline vs. lactated ringer's during renal transplantation.
OBJECTIVE
We hypothesized that normal saline (NS) may have more deleterious effects compared with lactated ringer (LR) in kidney transplant recipients because of the higher risk of acidosis and higher levels of serum potassium. Thus, the aim of this study was to determine the safety of LR if used during a renal transplant.


METHODS
Adults undergoing kidney transplantations were enrolled in a double-blinded randomized prospective clinical trial. They were divided into two groups in order to receive NS and LR infusion as intraoperative IV fluid replacement therapy.


RESULTS
There was a significant difference in the serum potassium level (p = .000) and the PH (p = .007) between the two groups at the end of transplantations. Two patients in the LR group lost their kidneys due to vascular graft thrombosis. In other words, hyperkalemia and acidosis occurred more frequently in the NS group while thrombotic events may be of concern in the LR group.


CONCLUSIONS
Compared with NS, LR infusion may lead to a lower serum potassium level and a lower risk of acidosis, while there is major concern of the hypercoagulable state in these patients.
Department of Anesthesiology, Sina Hospital, Medical Sciences University of Tehran, Tehran, Iran. moharari@sina.tums.ac.ir
Mohammad Reza
MR
Khajavi
Farhad
F
Etezadi
Reza Shariat
RS
Moharari
Farsad
F
Imani
Ali Pasha
AP
Meysamie
Patricia
P
Khashayar
Atabak
A
Najafi
D000138:Acidosis / Q000517:prevention & control; D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects; D004311:Double-Blind Method; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000627:therapeutic use*; D016030:Kidney Transplantation; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D000077325:Ringer's Lactate; D012965:Sodium Chloride
D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012965:Sodium Chloride; D011188:Potassium