Saline versus balanced crystalloids for hydration post-kidney biopsy.

Area of Science:

• Pediatric Nephrology
• Intravenous Fluid Therapy
• Clinical Trials

Background:

• Isotonic fluids are standard for hydration, yet optimal choices remain debated.
• Lack of consensus exists regarding the best isotonic solution for fluid therapy.

Purpose of the Study:

• To compare the efficacy of 0.9% sodium chloride (saline) versus balanced crystalloids in preventing hyponatremia post-pediatric kidney biopsy.
• To evaluate electrolyte and renal function changes associated with different isotonic fluid administrations.

Main Methods:

• A single-center, non-randomized controlled trial involving pediatric patients (1-19 years) undergoing kidney biopsies.
• Patients received either 0.9% sodium chloride or balanced crystalloids.
• Primary outcome: occurrence of hyponatremia (<137 mEq/L); secondary outcomes: electrolyte balance, blood gas, Cr-eGFR, and arginine vasopressin levels.

Main Results:

• No hyponatremia occurred in either group; serum sodium levels were comparable.
• The saline group exhibited a significant increase in serum chloride and a decrease in HCO3- compared to balanced crystalloids.
• Minimal changes in pH and creatinine-based estimated glomerular filtration rate (Cr-eGFR) were observed in both groups.

Conclusions:

• Both saline and balanced crystalloids are effective in preventing hyponatremia during pediatric kidney biopsies.
• While saline leads to higher chloride and lower bicarbonate levels, these changes have minimal clinical significance.