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Submitted: 11 Aug 2020
Accepted: 06 Dec 2020
ePublished: 15 Dec 2020
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J Renal Inj Prev. 2022;11(2): e22733.
doi: 10.34172/jrip.2022.22733

Scopus ID: 85130390729
  Abstract View: 2999
  PDF Download: 880

Original

Normal saline and acute kidney injury in hospitalized patients; more precaution to be taken

Kyaw Kyaw Hoe 1* ORCID logo, Swane Gardener 1 ORCID logo, Yvonne Dawkins 1 ORCID logo, Thant Hnin Saint Hoe 1 ORCID logo

1 University of the West Indies, Kingston, Jamaica
*Corresponding Author: Email: kyaw.hoe@uwimona.edu.jm

Abstract

Introduction: Potential nephrotoxic agents are not well recognized and are being used irrespective of patients’ vulnerability.

Objectives: We aimed to evaluate the relationship between the prevalence of exposure to normal saline and the risk of hospital acquired acute kidney injury (HA-AKI).

Patients and Methods: A retrospective case-control study of a total of 424 hospitalized patients was done. The frequency of exposure to the individual intravenous fluids and their risk of HA-AKI were calculated as odds ratios with 95% confidence interval (CI).

Results: Of 424 total sampled hospitalized patients, post-admission normal saline exposure was found in 37.6% in which 22.6% had the development of HA-AKI and 15% did not develop AKI. The risk of HA-AKI was significantly higher in patients who received normal saline and lower in patients who received 5% dextrose water (ORs; 1.92, 95% CI; 1.28, 2.85; P=0.001 and ORs; 0.48, 95% CI; 0.24, 0.95, P=0.02, respectively).

Conclusion: Exposure to normal saline was considerably high among hospitalized patients and was associated with a higher risk of AKI. Post-admission administration of high sodium and chloride containing intravenous fluid should be limited in patients who are vulnerable to develop AKI.


Implication for health policy/practice/research/medical education:

Our study results show that the risk of hospital acquired acute kidney injury (HA-AKI) is higher among patients who received normal saline as fluid therapy or volume replacement. Restriction of normal saline will be potentially beneficial in the prevention of HA-AKI.

Please cite this paper as: Kyaw Hoe K, Gardener S, Dawkins Y, Saint Hoe TH. Normal saline and acute kidney injury in hospitalized patients; more precaution to be taken. J Renal Inj Prev. 2022; 11(2): 22733. doi: 10.34172/jrip.2022.22733.

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