title: [Sodium chloride 0.9%: nephrotoxic crystalloid?].
abstract: Sodium chloride 0.9%, often incorrectly called physiological saline, contains higher concentration of chloride compared to plasma. It is known that the administration of sodium chloride 0.9% can cause hyperchloremic metabolic acidosis in a reproducible manner. The elevated chloride concentration in 0.9% NaCl solution can also adversely affect renal perfusion. This effect is thought to be induced by hyperchloremia that causes renal artery vasoconstriction. For these reasons, the use of 0.9% NaCl solution is raising attention and some would advocate the use of a more "physiological" solution, such as balanced solutions that contain a level of chloride closer to that of plasma. Few prospective, randomized, controlled trials are available today and most were done in a perioperative setting. Some studies suggest that the chloride excess in 0.9% NaCl solution could have clinical consequences; however, this remains to be established by quality randomized controlled trials.
authors.forename: Vincent
authors.initials: V
authors.lastname: Dombre
authors.forename: Sophie
authors.initials: S
authors.lastname: De Seigneux
authors.forename: Eduardo
authors.initials: E
authors.lastname: Schiffer
mesh_terms: D002712:Chlorides / Q000097:blood; D000077324:Crystalloid Solutions; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D007674:Kidney Diseases / Q000209:etiology* / Q000473:pathology; D012965:Sodium Chloride / Q000008:administration & dosage / Q000009:adverse effects*; D014661:Vasoconstriction / Q000187:drug effects
chemical_list: D002712:Chlorides; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D012965:Sodium Chloride