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Monday, May 7, 2018

Topic Discussion: Intravenous Fluids and the Kidney


Specific fluid
Fluid Type
Effect on the kidney
Evidence
Lactate Ringers
Crystalloid

None
SMART  and SALT-ED trial, NEJM 2018 and SPLIT trial JAMA 2015

0.9% Saline
Crystalloid

? more metabolic acidosis, ?AKI
SMART and SALT-ED trial, NEJM 2018 and SPLIT trial JAMA 2015

Albumin
Colloid
None to our knowledge

Hydroxyethyl starch

Colloid
Bad, AKI, osmotic nephrosis leading to more RRT


Pentastarch( low molecular weight Hydroxyethyl starch)

Colloid
Bad, AKI, osmotic nephrosis leading to more RRT

Dextrand

Colloid
Bad, AKI, osmotic nephrosis

PlasmaLyte

Crystalloid
None