Effect of Intra operative 0.9% Normal Saline vs Balanced Electrolyte solution on Ionic and Acid base status in patients with End stage Renal Disease undergoing Live Renal Transplantation

Geeta Kanithi; Srikanth Diddi; Prasad Rao K; R. Gopinath

Volume : VII, Issue : VII, July - 2017

Effect of Intra operative 0.9% Normal Saline vs Balanced Electrolyte solution on Ionic and Acid base status in patients with End stage Renal Disease undergoing Live Renal Transplantation

Geeta Kanithi, Srikanth Diddi, Prasad Rao K, R. Gopinath

Abstract :

Introduction

Patients undergoing Renal Transplantation are subjected to a wide variety of intraoperative complications including hemodynamic instability, acid–base and electrolyte disturbances because of impaired renal function, and co–morbid diseases. Maintenance of intravascular volume during kidney transplantation is crucial to ensure optimal graft perfusion and function. Aim

This study compared the effects of normal saline (NS) and Plasma–Lyte–A on acid–base balance and electrolytes during living donor kidney transplantation

Methods

Patients were randomized to an NS group (n = 15) or a Plasma–Lyte–A group (n = 15). Arterial blood samples were collected for acid–base analysis after induction of anesthesia (base line), before clamp release, 1 hour after clamp release, and at the end of surgery. All samples were analyzed using a blood–gas analyzer

Results: In Normal saline group compared to Plasma–Lyte A there was a significant decrease in pH, bicarbonate and base excess. No patient in either group developed clinically significant metabolic acidosis

Conclusion: Although we found no difference in immediate graft function between the 2 groups, we concluded that using Normal saline resulted in decrease in pH and hyperchloremia. Such derangements can be prevented by using balanced crystalloids.