生理盐水与平衡晶体在肾前急性肾损伤和既往慢性肾病患者中的应用

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Romanian Journal of Internal Medicine Pub Date : 2023-06-01 DOI:10.2478/rjim-2023-0007
Marios Papasotiriou, Adamantia Mpratsiakou, Georgia Georgopoulou, Theodoros Ntrinias, Lamprini Balta, Paraskevi Pavlakou, Dimitrios S Goumenos, Evangelos Papachristou
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引用次数: 0

摘要

简介:生理盐水(N/S)和乳酸林格氏盐(L/R)在日常临床实践中使用。尽管如此,N/S增加了钠超载和高氯血症代谢性酸中毒的风险。相比之下,L/R的钠含量较低,氯含量显著减少,并含有乳酸盐。在这项研究中,我们比较了肾前性急性肾损伤(AKI)和预先建立的慢性肾病(CKD)患者的L/R和N/S给药的疗效。方法:在这项前瞻性开放标签研究中,我们纳入了不需要透析的肾性AKI和先前已知的CKD III-V期患者。排除了其他形式的AKI、高容量血症或高钾血症患者。患者接受N/S或L/R静脉注射,剂量为20ml /kg体重/天。我们研究了出院时和30天时的肾功能、住院时间、酸碱平衡和透析的需要。结果:38例患者接受N/S治疗,20例患者接受N/S治疗。两组患者住院期间和出院后30天的肾功能改善情况相似。住院时间也相似。用Δanion-gap表示的阴离子间隙改善在L/R组与N/S组相比在出院和入院日之间更高,pH值升高(ΔpH)在L/R组略高。没有病人需要透析。结论:给予肾前性AKI和预先建立的CKD患者L/R或N/S对短期或长期肾功能无显著差异,但与N/S相比,L/R在酸碱平衡改善和Cl-超载方面表现更好。
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Normal saline versus balanced crystalloids in patients with prerenal acute kidney injury and pre-existing chronic kidney disease.

Introduction: Normal saline (N/S) and Ringer's-Lactate (L/R), are administered in everyday clinical practice. Despite that, N/S increases the risk of sodium overload and hyperchloremic metabolic acidosis. In contrast, L/R has lower sodium content, significantly less chloride and contains lactates. In this study we compare the efficacy of L/R versus N/S administration in patients with prerenal acute kidney injury (AKI) and pre-established chronic kidney disease (CKD).

Methods: In this prospective open-label study we included patients with prerenal AKI and previously known CKD stage III-V without need for dialysis. Patients with other forms of AKI, hypervolemia or hyperkalemia were excluded. Patients received either N/S or L/R intravenously at a dose of 20 ml/kg body-weight/day. We studied kidney function at discharge and at 30 days, duration of hospitalization, acid-base balance and the need for dialysis.

Results: We studied 38 patients and 20 were treated with N/S. Kidney function improvement during hospitalization and at 30 days after discharge, was similar between the two groups. Duration of hospitalization was also similar. Anion-gap improvement as expressed with Δanion-gap between discharge and admission day was higher in those patients that received L/R in comparison to those that received N/S and pH increase (ΔpH) was slightly higher in the L/R group. No patient required dialysis.

Conclusions: Administration of L/R or N/S to patients with prerenal AKI and pre-established CKD had no significant difference in short or long term kidney function but L/R showed a better profile in acid-base balance improvement and Cl- overload in comparison to N/S.

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来源期刊
Romanian Journal of Internal Medicine
Romanian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
5.30%
发文量
35
审稿时长
15 weeks
期刊介绍: Romanian Journal of Physics is a journal publishing physics contributions on the following themes: •Theoretical Physics & Applied Mathematics •Nuclear Physics •Solid State Physics & Materials Science •Statistical Physics & Quantum Mechanics •Optics •Spectroscopy •Plasma & Lasers •Nuclear & Elementary Particles Physics •Atomic and Molecular Physics •Astrophysics •Atmosphere and Earth Science •Environment Protection
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