ArticleKidney international reports2026
Randomized Clinical Trial of Ringer's Lactate Versus Chloride-Reduced Saline-Dextrose in Postoperative Kidney Transplantation.
Article in Kidney international reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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16 authors.
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Abstract
Introduction: Normal saline administration induces hyperchloremic metabolic acidosis, potentially impairing kidney allograft recovery. The comparative efficacy of balanced crystalloids against actively chloride-reduced saline protocols remains unclear. Methods: This randomized, open-label trial compared Ringer's Lactate Solution (RLS) with a dynamic dual-infusion protocol of normal saline and 5% dextrose (NSS + D5W) in adult kidney transplant recipients. Using a prespecified modified intention-to-treat analysis, 134 patients who received ≥2 L of study fluid were evaluated. Fluids were strictly titrated to hourly urine output. The primary outcome was day-4 serum bicarbonate. Secondary outcomes evaluated the overall treatment strategy, including protocolized rescue bicarbonate requirements, 1-month estimated glomerular filtration rate (eGFR) as an indicator of early functional recovery, and exploratory mechanistic biomarkers (urine neutrophil gelatinase-associated lipocalin [NGAL] and serum cytokines). Results: On postoperative day 4, the RLS group maintained significantly higher serum bicarbonate (19.39 vs. 17.31 mEq/L; Conclusion: RLS effectively reduces early postoperative metabolic acidosis and was associated with better short-term allograft functional recovery compared with a chloride-reduced saline regimen. These benefits are most applicable to allografts exhibiting immediate or early function that permits standard volume expansion.
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