Do the perioperative intravenous fluids affect kidney graft function and electrolytes in pediatric kidney transplantation?

Abstract

Abstract Background. The type and volume of intravenous fluids administered perioperatively for kidney transplant recipients may affect the graft function and induce electrolyte disturbances in these patients. We studied whether the type of intravenous fluids given during perioperative period affect kidney graft function and electrolyte balance in paediatric kidney transplant recipients. Methods. This retrospective study included all pediatric patients who underwent kidney transplantation at a single center between January 2014 and December 2022. We grouped patients based on the amount of normal saline (NS) they received: high NS (received >70% of their total fluids as NS) and low NS group (received <70% of their total fluids as NS). The outcome was the incidence of slow graft function, electrolyte disturbances and metabolic acidosis in the first 48 hours after surgery. Results. Of 78 patients who included, 29.5% had slow graft function on posttransplant day 2 with no significant difference between both groups. Hyperchloremia, hypokalemia, hyponatremia, hypernatremia, and hyperkalemia were observed in 42.3%, 26.9%, 24.4%, 5.1%, and 2.6%, respectively. Hypokalemia was less in low NS group. There is no significant difference between the groups regarding the metabolic acidosis (78% vs 62%). Conclusion. This study found that perioperative administration of normal saline at volumes greater than 70% of total fluids did not significantly affect the incidence of slow graft function, electrolyte disturbances, or metabolic acidosis in pediatric patients who underwent kidney transplantation.