Effects of normal saline vs. lactated ringer's during renal transplantation

We hypothesized that normal saline (NS) may have more deleterious effects compared with lactated ringer (LR) in kidney transplant recipients because of the higher risk of acidosis and higher levels of serum potassium. Thus, the aim of this study was to determine the safety of LR if used during a renal transplant.

Adults undergoing kidney transplantations were enrolled in a double-blinded randomized prospective clinical trial. They were divided into two groups in order to receive NS and LR infusion as intraoperative IV fluid replacement therapy.

There was a significant difference in the serum potassium level (p = .000) and the PH (p = .007) between the two groups at the end of transplantations. Two patients in the LR group lost their kidneys due to vascular graft thrombosis. In other words, hyperkalemia and acidosis occurred more frequently in the NS group while thrombotic events may be of concern in the LR group.

Compared with NS, LR infusion may lead to a lower serum potassium level and a lower risk of acidosis, while there is major concern of the hypercoagulable state in these patients.