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Ab-normal saline in abnormal kidney function: risks and alternatives.

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This summary is machine-generated.

0.9% saline, a common intravenous fluid, may cause harm, including acute kidney injury and metabolic acidosis, due to its high chloride content. Balanced crystalloid solutions are emerging as safer alternatives.

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Area of Science:

  • Intravenous fluid therapy
  • Clinical pharmacology
  • Nephrology

Background:

  • 0.9% saline is a widely used crystalloid solution in adult and pediatric care.
  • Concerns are rising regarding potential adverse effects associated with high chloride content in 0.9% saline.
  • These adverse effects include increased mortality, acute kidney injury (AKI), metabolic acidosis, and coagulopathy.

Purpose of the Study:

  • To review current evidence on the adverse effects of chloride-rich intravenous fluids.
  • To evaluate the continued use of 0.9% saline in clinical practice.
  • To compare 0.9% saline with balanced crystalloid solutions like PlasmaLyte.

Main Methods:

  • Literature review of studies investigating intravenous fluid therapy.
  • Analysis of evidence linking chloride concentration to patient outcomes.
  • Comparison of physiological effects of 0.9% saline and balanced crystalloid solutions.

Main Results:

  • Excess chloride in 0.9% saline is implicated as the primary cause of adverse sequelae.
  • Evidence suggests a link between 0.9% saline use and increased mortality, AKI, acidosis, and coagulopathy.
  • Balanced solutions may mitigate these risks.

Conclusions:

  • The high chloride load of 0.9% saline poses significant risks.
  • Balanced crystalloid solutions represent a potentially safer alternative to 0.9% saline.
  • Re-evaluation of 0.9% saline's role in modern fluid therapy is warranted.