The effect of different crystalloid solutions on acid-base balance and early kidney function after kidney transplantation

Anesth Analg. 2008 Jul;107(1):264-9. doi: 10.1213/ane.0b013e3181732d64.


Background: This study aimed to quantify changes in acid-base balance, potassium and lactate levels as a function of administration of different crystalloid solutions during kidney transplantation, and to determine the ideal fluid for such patients.

Methods: In this double-blind study, patients were randomized to three groups (n = 30 each) to receive either normal saline, lactated Ringer's, or Plasmalyte, all at 20-30 mL x kg(-1) x h(-1). Arterial blood analyses were performed before induction of anesthesia, and at 30-min intervals during surgery, and total IV fluids recorded. Urine volume, serum creatinine and BUN, and creatinine clearance were recorded on postoperative days 1, 2, 3, and 7.

Results: There was a statistically significant decrease in pH (7.44 +/- 0.50 vs 7.36 +/- 0.05), base excess (0.4 +/- 3.1 vs -4.3 +/- 2.1), and a significant increase in serum chloride (104 +/- 2 vs 125 +/- 3 mM/L) in patients receiving saline during surgery. Lactate levels increased significantly in patients who received Ringer's lactate (0.48 +/- 0.29 vs 1.95 +/- 0.48). No significant changes in acid-base measures or lactate levels occurred in patients who received Plasmalyte. Potassium levels were not significantly changed in any group.

Conclusions: All three crystalloid solutions can be safely used during uncomplicated, short-duration renal transplants; however, the best metabolic profile is maintained in patients who receive Plasmalyte.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acid-Base Equilibrium / drug effects*
  • Adolescent
  • Adult
  • Aged
  • Blood Urea Nitrogen
  • Creatinine / blood
  • Crystalloid Solutions
  • Double-Blind Method
  • Electrolytes / pharmacology
  • Humans
  • Hydrogen-Ion Concentration
  • Isotonic Solutions / pharmacology*
  • Kidney / physiopathology*
  • Kidney Transplantation*
  • Lactic Acid / blood
  • Middle Aged
  • Prospective Studies
  • Ringer's Lactate


  • Crystalloid Solutions
  • Electrolytes
  • Isotonic Solutions
  • Ringer's Lactate
  • Lactic Acid
  • Plasmalyte A
  • Creatinine