Comparison of the effects of normal saline versus Plasmalyte on acid-base balance during living donor kidney transplantation using the Stewart and base excess methods.

Published

Journal Article

BACKGROUND: Ischemia-reperfusion injury is an inevitable consequence of kidney transplantation, leading to metabolic acidosis. This study compared the effects of normal saline (NS) and Plasmalyte on acid-base balance and electrolytes during living donor kidney transplantation using the Stewart and base excess (BE) methods. METHODS: Patients were randomized to an NS group (n = 30) or a Plasmalyte group (n = 30). Arterial blood samples were collected for acid-base analysis after induction of anesthesia (T0), prior to clamping the iliac vein (T1), 10 minutes after reperfusion of the donated kidney (T2), and at the end of surgery (T3). In addition serum creatinine and 24-hour urine output were recorded on postoperative days 1,2, and 7. Over the first postoperative 7 days we recorded episodes of graft failure requiring dialysis. RESULTS: Compared with the Plasmalyte group, the NS group showed significantly lower values of pH, BE, and effective strong ion differences during the postreperfusion period (T2 and T3). Chloride-related values (chloride [Cl(-)], free-water corrected Cl(-), BEcl) were significantly higher at T1, T2, and T3, indicating hyperchloremic rather than dilutional metabolic acidosis. Early postoperative graft functions in terms of serum creatinine, urine output, and graft failure requiring dialysis were not significantly different between the groups. CONCLUSIONS: Both NS and Plamalyte can be used safely during uncomplicated living donor kidney transplantation. However, Plasmalyte more stably maintains acid-base and electrolyte balance compared with NS especially during the postreperfusion period.

Full Text

Duke Authors

Cited Authors

  • Kim, SY; Huh, KH; Lee, JR; Kim, SH; Jeong, SH; Choi, YS

Published Date

  • July 2013

Published In

Volume / Issue

  • 45 / 6

Start / End Page

  • 2191 - 2196

PubMed ID

  • 23953528

Pubmed Central ID

  • 23953528

Electronic International Standard Serial Number (EISSN)

  • 1873-2623

Digital Object Identifier (DOI)

  • 10.1016/j.transproceed.2013.02.124

Language

  • eng

Conference Location

  • United States