Renal-Friendly ORS: Evidence-Based Personalisation In Acute And Chronic Kidney Disease

Oral Rehydration Solution (ORS) is a life-saving therapy widely used for the management of dehydration, especially in diarrhoeal illnesses. However, in patients with acute kidney injury (AKI) or chronic kidney disease (CKD), including those with hypertension, oliguria, or fluid overload, standard ORS formulations may cause harm. These patients often present with impaired sodium and potassium handling, low urine output, and increased risk of volume overload or hyperkalaemia. This review summarises the limitations of conventional ORS in this population and provides evidence-based, stage-wise recommendations for renal-safe ORS formulations that consider fluid status, serum potassium levels, GFR, and comorbid conditions like hypertension.