The effect of different crystalloid solutions on acid-base balance and early kidney function after kidney transplantation.
BACKGROUND
This study aimed to quantify changes in acid-base balance, potassium and lactate levels as a function of administration of different crystalloid solutions during kidney transplantation, and to determine the ideal fluid for such patients.


METHODS
In this double-blind study, patients were randomized to three groups (n = 30 each) to receive either normal saline, lactated Ringer's, or Plasmalyte, all at 20-30 mL x kg(-1) x h(-1). Arterial blood analyses were performed before induction of anesthesia, and at 30-min intervals during surgery, and total IV fluids recorded. Urine volume, serum creatinine and BUN, and creatinine clearance were recorded on postoperative days 1, 2, 3, and 7.


RESULTS
There was a statistically significant decrease in pH (7.44 +/- 0.50 vs 7.36 +/- 0.05), base excess (0.4 +/- 3.1 vs -4.3 +/- 2.1), and a significant increase in serum chloride (104 +/- 2 vs 125 +/- 3 mM/L) in patients receiving saline during surgery. Lactate levels increased significantly in patients who received Ringer's lactate (0.48 +/- 0.29 vs 1.95 +/- 0.48). No significant changes in acid-base measures or lactate levels occurred in patients who received Plasmalyte. Potassium levels were not significantly changed in any group.


CONCLUSIONS
All three crystalloid solutions can be safely used during uncomplicated, short-duration renal transplants; however, the best metabolic profile is maintained in patients who receive Plasmalyte.
Hadimioglu
Necmiye
N
Department of Anesthesiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey. necmiye@akdeniz.edu.tr
Saadawy
Iman
I
Saglam
Tayyup
T
Ertug
Zeki
Z
Dinckan
Ayhan
A
D000136:Acid-Base Equilibrium / Q000187:drug effects*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D000077324:Crystalloid Solutions; D004311:Double-Blind Method; D004573:Electrolytes / Q000494:pharmacology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007552:Isotonic Solutions / Q000494:pharmacology*; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D019344:Lactic Acid / Q000097:blood; D008875:Middle Aged; D011446:Prospective Studies; D000077325:Ringer's Lactate
D000077324:Crystalloid Solutions; D004573:Electrolytes; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D019344:Lactic Acid; C048013:Plasmalyte A; D003404:Creatinine