Evidence map›Paper›PMID 37914088›Full record

Trial reportKidney international2024

A pragmatic, open-label, randomized controlled trial of Plasma-Lyte-148 versus standard intravenous fluids in children receiving kidney transplants (PLUTO).

Wesley N Hayes, Emma Laing, Rosemary Brown, Laura Silsby, Laura Smith, Helen Thomas, Fotini Kaloyirou, Rupa Sharma, James Griffiths, Helen Hume-Smith and 14 more

Open access · hybridAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Kidney international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.8field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 11 institutions in 2 countries.

Wesley N HayesDepartment of Pediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; University College London Great Ormond Street Institute of Child Health, London, UK. Electronic address: wesley.hayes@gosh.nhs.uk.
Emma LaingNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
Rosemary BrownNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
Laura SilsbyNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
Laura SmithNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
Helen ThomasNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
Fotini KaloyirouNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
Rupa SharmaNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
James GriffithsNational Health Service Blood and Transplant Clinical Trials Unit, Cambridge, UK.
Helen Hume-SmithDepartment of Anesthetics, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Stephen D MarksDepartment of Pediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; University College London Great Ormond Street Institute of Child Health, London, UK.
Nicos KessarisDepartment of Transplant Surgery, Guys and St Thomas NHS Foundation Trust, London, UK.
Martin ChristianDepartment of Pediatric Nephrology, Nottingham Children's Hospital, Nottingham, UK.
Jan DudleyDepartment of Pediatric Nephrology, Bristol Children's Hospital, Bristol, UK.
Mohan ShenoyDepartment of Pediatric Nephrology, Manchester Children's Hospital, Manchester, UK.
Michal MalinaDepartment of Pediatric Nephrology, Great North Children's Hospital, Newcastle, UK.
Mordi MuorahDepartment of Pediatric Nephrology, Birmingham Children's Hospital, Birmingham, UK.
Nicholas WareDepartment of Pediatric Nephrology, Evelina Childrens Hospital, London, UK.
Pallavi YadavDepartment of Pediatric Nephrology, Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK.
Ben ReynoldsDepartment of Pediatric Nephrology, Glasgow Hospital for Sick Children, Glasgow, UK.
William BryantDepartment of Data Research Innovation and Virtual Environments, Great Ormond Street Hospital for Children, London, UK.
Anastassia SpiridouDepartment of Data Research Innovation and Virtual Environments, Great Ormond Street Hospital for Children, London, UK.
Jo WrayDepartment of Psychology, Great Ormond Street Hospital for Children, London, UK.
Mark J PetersUniversity College London Great Ormond Street Institute of Child Health, London, UK; Pediatric Intensive Care Unit, Great Ormond Street Hospital for Children, London, UK.
National Health Service · GBGreat Ormond Street Hospital · GBBirmingham Children's Hospital · GBBristol Royal Hospital for Children · GBEvelina London Children's Healthcare · GBGreat North Children's Hospital · GBGreat Ormond Street Hospital for Children NHS Foundation Trust · GBGuy's and St Thomas' NHS Foundation Trust · GBLeeds Teaching Hospitals NHS Trust · GBRoyal Hospital for Children · GBRoyal Manchester Children's Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Acute electrolyte and acid-base imbalance is experienced by many children following kidney transplant. This is partly because doctors give very large volumes of artificial fluids to keep the new kidney working. When severe, fluid imbalance can lead to seizures, cerebral edema and death. In this pragmatic, open-label, randomized controlled trial, we randomly assigned (1:1) pediatric kidney transplant recipients to Plasma-Lyte-148 or standard of care perioperative intravenous fluids (predominantly 0.45% sodium chloride and 0.9% sodium chloride solutions). We then compared clinically significant electrolyte and acid-base abnormalities in the first 72 hours post-transplant. The primary outcome, acute hyponatremia, was experienced by 53% of 68 participants in the Plasma-Lyte-148 group and 58% of 69 participants in the standard fluids group (odds ratio 0·77 (0·34 - 1·75)). Five of 16 secondary outcomes differed with Plasma-Lyte-148: hypernatremia was significantly more frequent (odds ratio 3·5 (1·1 - 10·8)), significantly fewer changes to fluid prescriptions were made (rate ratio 0·52 (0·40-0·67)), and significantly fewer participants experienced hyperchloremia (odds ratio 0·17 (0·07 - 0·40)), acidosis (odds ratio 0·09 (0·04 - 0·22)) and hypomagnesemia (odds ratio 0·21 (0·08 - 0·50)). No other secondary outcomes differed between groups. Serious adverse events were reported in 9% of participants randomized to Plasma-Lyte-148 and 7% of participants randomized to standard fluids. Thus, perioperative Plasma-Lyte-148 did not change the proportion of children who experienced acute hyponatremia compared to standard fluids. However fewer fluid prescription changes were made with Plasma-Lyte-148, while hyperchloremia and acidosis were less common.

Indexed as

AcidosisHyponatremiaKidney TransplantationWater-Electrolyte ImbalanceChildElectrolytesFluid TherapyGluconatesHumansIsotonic SolutionsMagnesium ChloridePotassium ChlorideSodium AcetateSodium ChlorideElectrolytesGluconatesIsotonic SolutionsMagnesium ChloridePlasma-lyte 148Potassium ChlorideSodium AcetateSodium Chloridehyponatremiapediatric nephrologytransplantation

Identifiers

PMID37914088
PMCPMC10804931
OpenAlexW4388084906

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.