Lactated Ringer's vs. normal saline solution for renal transplantation: Systematic review and meta-analysis

  • Jorge Alejandro Trujillo-Zea Universidad Pontificia Bolivariana, Medellín, Colombia
  • Natalia Aristizábal-Henao Universidad Pontificia Bolivariana, Medellín, Colombia
  • Nelson Fonseca-Ruiz Universidad Pontificia Bolivariana, Medellín, Colombia
Keywords: Kidney transplantation, Acidosis, Hyperkalemia, Sodium chloride, Perioperative Period


Background: The administration of potassium solutions may result in hyperpotassemia during surgery; normal saline solution (NSS) traditionally used in renal transplant may cause hyperchloremic acidosis.

Objective: To compare the safety of Lactated Ringer's (LR) against NSS in renal transplantation.

Search strategy: A systematic review was completed on Central Cochrane Registry - controlled trials, Medline, Lilacs, EBSCO and Embase, accessing review articles and contacting expert clinicians. There was no language restriction.

Selection criteria: Randomized controlled trials on adult patients undergoing renal transplantation.

Data collection and analysis: Independent trial selection, quality assessment and data extraction were performed. The mean differentials were estimated with a 95% confidence interval (95% CI). Heterogeneity was evaluated with statistic I-square(I2) and the fixed and random effect models were used.

Results: Four trials with a total of 237 patients were included. At the end of surgery, the potassium differential was non-significant (means difference (MD: -0.26 mEq/L; CI 95%: -0.58 to 0.05 = 0.10; I2 = 75%); the pH was lower in the NSS group (MD: 0.06; CI 95%: 0.05-0.08; < 0.001; I2 = 17%). No difference in Creatinine was identified on the third postoperative day (MD: -0.05; CI 95%: -0.59 to 0.48; = 0.85; I2 = 0%).

Condusions: The use of RL vs. NSS during the renal transplantation perioperative period results in lower potassium and chloride levels and a higher pH, with no significant Creatinine changes.


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How to Cite
Trujillo-Zea JA, Aristizábal-Henao N, Fonseca-Ruiz N. Lactated Ringer’s vs. normal saline solution for renal transplantation: Systematic review and meta-analysis. Colomb. J. Anesthesiol. [Internet]. 2015Jul.1 [cited 2021Sep.27];43(3):194-03. Available from:


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How to Cite
Trujillo-Zea JA, Aristizábal-Henao N, Fonseca-Ruiz N. Lactated Ringer’s vs. normal saline solution for renal transplantation: Systematic review and meta-analysis. Colomb. J. Anesthesiol. [Internet]. 2015Jul.1 [cited 2021Sep.27];43(3):194-03. Available from:

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