The Effects of 0.45% and 0.9% Saline Solutions on Serum Sodium Concentrations in Chronic Renal Failure Patients

Kwon, Min Ah; Kim, Gaab Su; Hong, Jung Kil; Jo, Hyun Sung; Kim, Jin Kyung; Yang, Mi Kyung; Lee, Byung Dal

Abstract

BACKGORUND: To choose optimal potassium free solutions in chronic renal failure patients, we studied the effects of 0.45% or 0.9% saline solutions on the serum sodium concentrations of patients undergoing kidney transplantation surgery.
METHODS
Sixty two patients, ASA physical status iii iV, undergoing kidney transplantation surgery, were allocated to receive either 0.45% saline (n = 26) or 0.9% saline solutions (n = 36). The patients received 2 L of 0.45% or 0.9% saline solutions with a CVP of 10 mmHg prior to a renal vein anastomosis. Serum sodium and potassium concentrations were measured before (Na0, K0) and after the administration of 2 L of 0.45% or 0.9% saline solutions (Na2, K2), respectively.
RESULTS
Serum sodium concentrations decreased after the administration of 0.45% saline solutions, and after administrating 2 L of 0.9% saline, the serum sodium concentrations increased in patients with baseline serum sodium concentrations lower than 136 mEq/L. When we administered 0.9% saline, which had a sodium concentration lower than the serum sodium concentration, the serum sodium concentration measured after 2 L of 0.9% saline infusion proportionally decreased in patients with baseline serum sodium concentration greater than 136 mEq/L (P<0.001).
CONCLUSiONS
For ideal fluid selection in chronic renal failure patients, this study suggests a 0.45% saline solution for chronic renal failure patients with a baseline serum sodium concentration below the normal range and a 0.9% saline solution for patients with a baseline sodium concentration within the normal range.