Key result
Plasma-Lyte reduces delayed graft function ~18% vs. normal saline in ESRD renal transplants.
Why the study?
The effects of intraoperative intravenous fluid choices on kidney function during renal transplantation remain unclear.
Do alternative intraoperative intravenous fluids reduce delayed graft function in ESRD patients undergoing renal transplantation compared to normal saline?
Meta-Analysis
Do alternative intraoperative intravenous fluids reduce delayed graft function in ESRD patients undergoing renal transplantation compared to normal saline?
Relative Risk: 0.82 (95% CI 0.69–0.96)
In ESRD patients undergoing renal transplantation, intraoperative use of Plasma-Lyte reduces the risk of delayed graft function compared to normal saline.
Supports preferring Plasma-Lyte to normal saline in renal transplantation; confirms benefit via Level 1 meta-analysis.
The effects of intraoperative intravenous (IV) fluids choices on kidney function during renal transplantation remain unclear. This meta-analysis compared the effectiveness of normal saline with that of alternative colloids and crystalloids in end-stage renal disease (ESRD) patients who underwent renal transplantation. We searched PubMed, Embase, and Cochrane Library to April 2025. Randomized control trials comparing normal saline with IV fluids were included. The primary outcome was delayed graft function. Secondary outcomes were total fluid volume, renal function, and perioperative ion change. Sixteen trials were analyzed with random-effects model. The pooled results for delayed graft function revealed that Plasma-Lyte was associated with a significantly lower incidence rate (risk ratio = 0.82, 95% confidence interval [CI] = 0.69-0.96) than normal saline. Serum creatinine levels on day 7 revealed that lactated Ringers (mean difference [MD] = -0.08, 95% CI = -0.15 to -0.01) and sodium bicarbonate (MD = -0.21, 95% CI = -0.41 to -0.01) groups had significantly lower creatinine levels than did the normal saline group. In conclusion, Plasma-Lyte led to a more favorable short-term graft function and perioperative ion status, which may be considered a practical option in ESRD patients undergoing kidney transplantation. Prospective controlled studies are warranted to corroborate these findings.
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Chang et al. (2025) conducted a meta-analysis in end-stage renal disease (ESRD) undergoing renal transplantation. Alternative IV fluids (e.g., Plasma-Lyte) vs. Normal saline was evaluated on delayed graft function (RR 0.82, 95% CI 0.69-0.96). Plasma-Lyte was associated with a significantly lower incidence of delayed graft function compared to normal saline (RR 0.82; 95% CI 0.69-0.96) in ESRD patients undergoing renal transplantation.
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