Balanced crystalloids vs normal saline in kidney injury

Jürgen Floege

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.

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