Do we have enough evidence to always prefer balanced crystalloids over normal saline in patients with kidney injury?
Jürgen Floege, MD: No, not really. There is evidence that only giving sodium chloride can induce harm, mostly via the chloride. But the evidence also suggests that you need very large amounts, 3 L or more, and that the risk in general is relatively low.
So with balanced solutions yes, you can be on the safer side, but I think it is overstating that you should by all means avoid sodium chloride.