Weinberg L, et al. – The risk of hyperkalaemia or postoperative graft function was assessed in patients who underwent deceased donor renal transplantation and received normal saline (NS) or Plasma–Lyte 148 (PL) during intraoperative and early postoperative period. The incidence of hyperkalaemia and hyperchloraemia was found to be greater among those who received NS versus PL. NS administration resulted in greater acidaemia relative to PL but no association of these biochemical differences with adverse clinical outcomes was apparent.

Methods

• Researchers compared NS with Plasma-Lyte 148 (PL) given during surgery and for 48 h after surgery in patients undergoing deceased donor renal transplantation.
• Hyperkalaemia within 48 h after surgery was the primary outcome.
• Secondary outcomes were need for hyperkalaemia treatment, change in acid–base status, and graft function.

Results

• Data reported that 25 subjects were randomized to NS and 24 to PL.
• Researchers observed that the incidence of hyperkalaemia in the first 48 h after surgery was higher in the NS group; 20 patients (80%) vs 12 patients (50%) in the PL group (risk difference: 0.3; 95% confidence interval: 0.05, 0.55; P=0.037).
• Findings demonstrated that the mean (SD) peak serum potassium was NS 6.1 (0.8) compared with PL 5.4 (0.9) mmol litre^-1 (P=0.009).
• In addition, it was noted that 16 participants (64%) in the NS group required treatment for hyperkalaemia compared with five (21%) in the PL group (P=0.004).
• Data highlighted that participants receiving NS were more acidaemic [pH 7.32 (0.06) vs 7.39 (0.05), P=0.001] and had higher serum chloride concentrations (107 vs 101 mmol litre^-1, P<0.001) at the end of surgery.
• Researchers observed no differences in the rate of delayed graft function.
• Subjects receiving PL who did not require dialysis had a greater reduction in creatinine on day 2 (P=0.04).