ReviewAmerican journal of physiology. Renal physiology2019
"I don't get no respect": the role of chloride in acute kidney injury.
Review in American journal of physiology. Renal physiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
48 citing papers in PubMed, 98 citations in OpenAlex.
- 5% Dextrose in Ringer's Lactate versus 5% Dextrose Normal Saline as Maintenance Intravenous Fluid Therapy in Children - A Randomised Controlled Trial.Indian journal of pediatrics · 2025Trial
- Trial
- The 'Chloride Theory' for Heart Failure Pathophysiology: An Updated Narrative Review 2025.Cardiology and therapy · 2026Review
- Ringer Lactate Versus Hybrid Isotonic/Hypotonic Saline in Delayed Graft Function in Deceased-donor Kidney Transplantation: A Real-world Protocol Change Study.Transplantation direct · 2026Article
- Perioperative fluid management in kidney transplantation: What's new and future directives?World journal of nephrology · 2026Review
- Revisiting acute kidney injury outcomes in traumatic brain injury.World journal of critical care medicine · 2026Article
- Comparison of the endoscopic surgical monitoring system and blood parameters for evaluating irrigation fluid absorption during bipolar plasmakinetic transurethral resection of the prostate: a prospective observational study.BMC anesthesiology · 2026Observational
- Association of a dual-index phenotype and early ICU reassessment with 28-day in-hospital mortality in cardiogenic shock: a single-center observational cohort study.Frontiers in cardiovascular medicine · 2026Article
- Palmitic Acid-induced Renal Injury: Unravelling the Molecular Mechanisms and the Protective Role of Lycopene.Cell biochemistry and biophysics · 2025Article
- Green Synthesis of Silver Nanoparticles Using Cynoglossum creticum Leaf Extract: Eco-Friendly Approach for Antibacterial, Antioxidant, and Sensing Applications.Applied biochemistry and biotechnology · 2025Article
- Initial serum chloride is associated with all-cause mortality in critically ill patients with acute kidney injury.Renal failure · 2025Article
- Acute Kidney Injury in Children with Type 1 Diabetes Mellitus Hospitalized for Diabetic Ketoacidosis: A Retrospective Study.Journal of the ASEAN Federation of Endocrine Societies · 2025Article
- Acute and sub-acute toxicity assessment of methanolic stem bark extract of Khaya anthotheca (Meliaceae) in Wistar rats.Tropical medicine and health · 2025Article
- Predicting In-Hospital Mortality in Intensive Care Unit Patients Using Causal SurvivalNet With Serum Chloride and Other Causal Factors: Cross-Country Study.Journal of medical Internet research · 2025Article
- Refractory metabolic acidosis and acute abdominal compartment syndrome following Holmium Laser Enucleation of Prostate (HoLEP).Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2025Article
- Stewart's theory and acid-base changes induced by crystalloid infusion in humans: a randomized physiological trial.Annals of intensive care · 2025Article
- Impact of early CVP monitoring on 1-year mortality in patients with congestive heart failure in the ICU: a retrospective analysis based on the MIMIC-IV2.2 database.BMC cardiovascular disorders · 2025Article
- Plasma expansion and renal perfusion in critical COVID-19 with AKI: A prospective case control study.Acta anaesthesiologica Scandinavica · 2025Article
- Association of serum chloride levels with all-cause mortality among patients in surgical intensive care units: a retrospective analysis of the MIMIC-IV database.BMC anesthesiology · 2025Article
- Balanced Electrolyte Solutions Versus 0.9% Saline for Kidney Transplantation: An Updated Systematic Review and Meta-analysis.Transplantation direct · 2025Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Acute kidney injury (AKI) is a major public health problem that complicates 10-40% of hospital admissions. Importantly, AKI is independently associated with increased risk of progression to chronic kidney disease, end-stage renal disease, cardiovascular events, and increased risk of in-hospital and long-term mortality. The chloride content of intravenous fluid has garnered much attention over the last decade, as well as its association with excess use and adverse outcomes, including AKI. Numerous studies show that changes in serum chloride concentration, independent of serum sodium and bicarbonate, are associated with increased risk of AKI, morbidity, and mortality. This comprehensive review details the complex renal physiology regarding the role of chloride in regulating renal blood flow, glomerular filtration rate, tubuloglomerular feedback, and tubular injury, as well as the findings of clinical research related to the chloride content of intravenous fluids, changes in serum chloride concentration, and AKI. Chloride is underappreciated in both physiology and pathophysiology. Although the exact mechanism is debated, avoidance of excessive chloride administration is a reasonable treatment option for all patients and especially in those at risk for AKI. Therefore, high-risk patients and those with "incipient" AKI should receive balanced solutions rather than normal saline to minimize the risk of AKI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.