Abstract | BACKGROUND: Kidney transplant recipients often receive large volumes of intravenous fluid replacement in the peri-operative period. Administration of 0.9% saline has previously been associated with acidosis, hyperkalaemia and acute kidney injury. The perioperative use of physiologically balanced replacement fluids may reduce the incidence of post-operative renal replacement therapy and hyperkalaemia. METHODS: A retrospective review of consecutive renal transplants before and after a change in perioperative fluid prescription from 0.9% saline to Plasma-Lyte 148. RESULTS: A total of 97 patients were included in the study, 59 receiving exclusively 0.9% saline and 38 receiving exclusively Plasma-Lyte. Patients in the Plasma-Lyte group were less likely to require emergency postoperative dialysis than those receiving 0.9% saline [odds ratio (OR) 0.15 (95% confidence interval 0.03-0.48), P = 0.004], and these patients had more favourable biochemical parameters with less hyperkalaemia, less acidosis and better diuresis. Patients in the Plasma-Lyte group also had a shorter length of hospital stay (7 days versus 11 days; P < 0.0001) and better graft function at 3 months postoperatively (estimated glomerular filtration rate 51 versus 44 mL/min/1.73 m2; P = 0.03); however, there was no difference in graft function at 1 year. CONCLUSIONS:
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Authors | Anamika Adwaney, David W Randall, Mark J Blunden, John R Prowle, Christopher J Kirwan |
Journal | Clinical kidney journal
(Clin Kidney J)
Vol. 10
Issue 6
Pg. 838-844
(Dec 2017)
ISSN: 2048-8505 [Print] England |
PMID | 29225814
(Publication Type: Journal Article)
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