title: A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers.
abstract: OBJECTIVE
  We compared the effects of intravenous infusions of 0.9% saline ([Cl] 154 mmol/L) and Plasma-Lyte 148 ([Cl] 98 mmol/L, Baxter Healthcare) on renal blood flow velocity and perfusion in humans using magnetic resonance imaging (MRI).
  
  
  BACKGROUND
  Animal experiments suggest that hyperchloremia resulting from 0.9% saline infusion may affect renal hemodynamics adversely, a phenomenon not studied in humans.
  
  
  METHODS
  Twelve healthy adult male subjects received 2-L intravenous infusions over 1 hour of 0.9% saline or Plasma-Lyte 148 in a randomized, double-blind manner. Crossover studies were performed 7 to 10 days apart. MRI scanning proceeded for 90 minutes after commencement of infusion to measure renal artery blood flow velocity and renal cortical perfusion. Blood was sampled and weight recorded hourly for 4 hours.
  
  
  RESULTS
  Sustained hyperchloremia was seen with saline but not with Plasma-Lyte 148 (P < 0.0001), and fall in strong ion difference was greater with the former (P = 0.025). Blood volume changes were identical (P = 0.867), but there was greater expansion of the extravascular fluid volume after saline (P = 0.029). There was a significant reduction in mean renal artery flow velocity (P = 0.045) and renal cortical tissue perfusion (P = 0.008) from baseline after saline, but not after Plasma-Lyte 148. There was no difference in concentrations of urinary neutrophil gelatinase-associated lipocalin after the 2 infusions (P = 0.917).
  
  
  CONCLUSIONS
  This is the first human study to demonstrate that intravenous infusion of 0.9% saline results in reductions in renal blood flow velocity and renal cortical tissue perfusion. This has implications for intravenous fluid therapy in perioperative and critically ill patients. NCT01087853.
authors.affiliation: Division of Gastrointestinal Surgery, Nottingham University Hospitals, Queen’s Medical Centre, Nottingham NG7 2UH, UK.
authors.forename: Abeed H
authors.initials: AH
authors.lastname: Chowdhury
authors.forename: Eleanor F
authors.initials: EF
authors.lastname: Cox
authors.forename: Susan T
authors.initials: ST
authors.lastname: Francis
authors.forename: Dileep N
authors.initials: DN
authors.lastname: Lobo
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects*; D002314:Cardioplegic Solutions / Q000494:pharmacology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005942:Gluconates / Q000494:pharmacology; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney; D015636:Magnesium Chloride / Q000494:pharmacology; D008279:Magnetic Resonance Imaging; D008297:Male; D011189:Potassium Chloride / Q000494:pharmacology; D019346:Sodium Acetate / Q000494:pharmacology; D012965:Sodium Chloride / Q000494:pharmacology*; D055815:Young Adult
chemical_list: D002314:Cardioplegic Solutions; D005942:Gluconates; C012499:Plasma-lyte 148; D015636:Magnesium Chloride; D012965:Sodium Chloride; D019346:Sodium Acetate; D011189:Potassium Chloride