In today’s journal club we analysed an interesting paper looking at the role of a chloride restrictive approach to fluid therapy for minimising the risk of AKI. The authors start by discussing some of the experimental data that suggests the high amounts of chloride in some commonly used fluids impairs renal function with effects such as renal vasoconstriction and reduced urine output. They note that there was little clinical evidence of this harm at the time of the study (published in 2012) and hence embarked on this particular project. The full text is available at the link below (free) but I also advise having a quick look at the supplementary materials and letters.
Association between a chloride liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults
Association between a chloride liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults
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