A Comparison Between Saline and Balanced Solutions in Kidney Transplants: A Randomized Clinical Trial.

Autor:	Medeiros H; Department of Anesthesiology, Hospital Universitário Onofre Lopes, Natal, BRA., Lima PH; Department of Anesthesiology, Hospital Universitário Onofre Lopes, Natal, BRA., Junior VS; Department of Anesthesiology, Hospital Universitário Onofre Lopes, Natal, BRA., Souza DA; Department of Anesthesiology, Hospital Universitário Onofre Lopes, Natal, BRA., Pinheiro AM; Department of Anesthesiology, Hospital Universitário Onofre Lopes, Natal, BRA., Martins RR; Graduate Program of Pharmaceutical Assistance, Universidade Federal do Rio Grande do Norte, Natal, BRA., A H Costa KM; Department of Nephrology, Universidade Federal do Rio Grande do Norte, Natal, BRA., Junior JHD; Department of Urology, Hospital Universitário Onofre Lopes, Natal, BRA., Medeiros PJ; Department of Urology, Hospital Universitário Onofre Lopes, Natal, BRA., Da Silva WA Sr; Department of Anesthesiology, Hospital Universitário Onofre Lopes, Natal, BRA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Dec 01; Vol. 15 (12), pp. e49813. Date of Electronic Publication: 2023 Dec 01 (Print Publication: 2023).
DOI:	10.7759/cureus.49813
Abstrakt:	Objective This study aimed to investigate the impact of different types of intravenous fluids - normal saline (NS), lactated Ringer's solution (LR), and PlasmaLyte (PL) - on the acid-base balance and electrolyte concentration following kidney transplant, a common procedure for patients with end-stage renal disease (ESRD). Methodology A randomized controlled trial design was employed, wherein the primary parameters analyzed were postoperative pH and serum potassium levels. Postoperative concentrations of serum bicarbonate, sodium, chloride, and creatinine, as well as graft functionality, were assessed as secondary outcomes. These measurements were performed at the start and end of surgery, as well as 24 and 72 hours postoperatively. Results A total of 53 patients were included in the study and randomized into three cohorts: NS, LR, and PL, each of which showed comparability in terms of demographic and transplantation specifics. Notably, patients in the NS group exhibited a more significant decrease in pH (NS group: 7.285 ±0.098, LR group: 7.324 ±0.075, PL group: 7.7338 ±0.059) and bicarbonate levels (17.0 ±4.2, 20.9 ±2.8, 20.0 ±4.5) post 24 hours after the operation and displayed a similar pattern immediately after the surgery. However, there were no discernible differences in potassium (p=0.460), sodium (p=0.681), and chloride (p=0.321) levels across the groups. Furthermore, the study did not observe any significant differences in postoperative graft functionality. Conclusion The use of NS as the intraoperative fluid of choice led to lower pH and bicarbonate levels following kidney transplant, as compared to LR and PL. However, these results did not correlate with improvements in graft functionality. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Medeiros et al.)
Databáze:	MEDLINE
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