{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:38:19Z","timestamp":1787071099566,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Normal saline is commonly used in the perioperative kidney transplant period; its high chloride content can cause hyperchloremic metabolic acidosis giving a possible advantage to balanced electrolyte solutions due to their lower chloride content. The evidence regarding the best practices in fluid management during kidney transplantation and its effect on the incidence of delayed graft function (DGF) is still limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>One hundred thirty-eight patients were included and followed up for seven days after surgery. Administered crystalloid type and volume were compared among patients with and without DGF, along with additional patient and surgical variables. To investigate whether intraoperative fluid type\/amount influence DGF, patients were categorized into three groups: those who received mainly (&gt;50%) lactated Ringer\u2019s solution, normal saline, or plasmaLyte. A logistic regression analysis was used to define variables independently correlated with DGF, and odds ratios (OR) with a 95% confidence interval (CI) were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The incidence of DGF was 8.7%. Cold ischemia time independently increased the odds of DGF (OR = 1.006 (95% CI: 1.002\u20131.011) while fluid type (saline versus PlasmaLyte OR = 5.28, 95% CI: 0.76\u201336.88) or amount (OR = 1.00, 95% CI: 1.00\u20131.01) did not significantly modify the odds of DGF. Central venous pressure, systolic blood pressure, and mean arterial pressure were higher in the non-DGF group, but this was not statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05). Significant intraoperative acidosis developed in patients who received normal saline compared to those in PlasmaLyte and lactated Ringer\u2019s groups; however, acid\u2013base balance and electrolytes did not vary significantly between the DGF and non-DGF groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>DGF was primarily influenced by surgical factors such as cold ischemia time, whereas intraoperative fluid type or amount did not affect DGF incidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_334_21","type":"journal-article","created":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T11:41:25Z","timestamp":1641296485000},"page":"38-44","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Crystalloid fluids and delayed graft function in kidney transplant: A cohort study"],"prefix":"10.4103","volume":"16","author":[{"given":"Amr","family":"ALKouny","sequence":"first","affiliation":[{"name":"Department of Anesthesia, King Abdul Aziz Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed K.","family":"ALHarbi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, College of Medicine, King Saud Bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman R.","family":"ALTheaby","sequence":"additional","affiliation":[{"name":"Department of Adult Nephrology and Renal Transplantation, King Abdul Aziz Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghaleb","family":"Aboalsamh","sequence":"additional","affiliation":[{"name":"Department of Organ Transplantation and Hepatobiliary Surgery, King Abdul Aziz Medical City, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amel","family":"Fayed","sequence":"additional","affiliation":[{"name":"College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,1,4]]},"reference":[{"key":"R1-20250925","first-page":"1","article-title":"The UNOS Renal Transplant Registry: Review of the Last Decade","author":"Andre","year":"2014","journal-title":"Clin Transpl"},{"key":"R2-20250925","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1111\/j.1432-2277.2006.00356.x","article-title":"Perioperative fluid management in renal transplantation: A narrative review of the literature","volume":"19","author":"Schnuelle","year":"2006","journal-title":"Transpl Int"},{"key":"R3-20250925","doi-asserted-by":"crossref","first-page":"4217","DOI":"10.1016\/S0041-1345(98)01397-9","article-title":"The nature of ischemia\/reperfusion injury","volume":"30","author":"Massberg","year":"1998","journal-title":"Transplant Proc"},{"key":"R4-20250925","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1016\/S0140-6736(04)17406-0","article-title":"Delayed graft function in kidney transplantation","volume":"364","author":"Perico","year":"2004","journal-title":"Lancet (London, England)"},{"key":"R5-20250925","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/j.transproceed.2012.05.042","article-title":"Do intraoperative hemodynamic factors of the recipient influence renal graft function?","volume":"44","author":"Campos","year":"2012","journal-title":"Transplant Proc"},{"key":"R6-20250925","doi-asserted-by":"crossref","first-page":"3387","DOI":"10.1016\/j.transproceed.2010.08.042","article-title":"The influence of intraoperative central venous pressure on delayed graft function in renal transplantation: A single-center experience","volume":"42","author":"Bacchi","year":"2010","journal-title":"Transplant Proc"},{"key":"R7-20250925","doi-asserted-by":"crossref","first-page":"174","DOI":"10.4103\/0970-9185.155144","article-title":"Influence of hemodynamics and intra-operative hydration on biochemical outcome of renal transplant recipients","volume":"31","author":"Aulakh","year":"2015","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R8-20250925","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1139\/y83-207","article-title":"Modern quantitative acid-base chemistry","volume":"61","author":"Stewart","year":"1983","journal-title":"Can J Physiol Pharmacol"},{"key":"R9-20250925","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1172\/JCI110820","article-title":"Regulation of renal blood flow by plasma chloride","volume":"71","author":"Wilcox","year":"1983","journal-title":"J Clin Invest"},{"key":"R10-20250925","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1056\/NEJMoa1711586","article-title":"Balanced crystalloids versus saline in noncritically ill adults","volume":"378","author":"Self","year":"2018","journal-title":"N Engl J Med"},{"key":"R11-20250925","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1213\/01.ANE.0000150939.28904.81","article-title":"A randomized, double-blind comparison of lactated Ringer's solution and 0.9% NaCl during renal transplantation","volume":"100","author":"O'Malley","year":"2005","journal-title":"Anesth Analg"},{"key":"R12-20250925","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1213\/ane.0b013e3181732d64","article-title":"The effect of different crystalloid solutions on acid-base balance and early kidney function after kidney transplantation","volume":"107","author":"Hadimioglu","year":"2008","journal-title":"Anesth Analg"},{"key":"R13-20250925","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1080\/08860220802064770","article-title":"Effects of normal saline vs.lactated ringer's during renal transplantation","volume":"30","author":"Khajavi","year":"2008","journal-title":"Ren Fail"},{"key":"R14-20250925","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1016\/j.transproceed.2013.02.124","article-title":"Comparison of the effects of normal saline versus Plasmalyte on acid-base balance during living donor kidney transplantation using the Stewart and base excess methods","volume":"45","author":"Kim","year":"2013","journal-title":"Transplant Proc"},{"key":"R15-20250925","first-page":"CD010741","article-title":"Normal saline versus lower-chloride solutions for kidney transplantation","author":"Wan","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"R16-20250925","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1177\/1089253220901665","article-title":"Intravenous fluid management practices in kidney transplant patients: A multicenter observational cohort pilot study","volume":"24","author":"Efune","year":"2020","journal-title":"Semin Cardiothorac Vasc Anesth"},{"key":"R17-20250925","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1213\/ANE.0b013e3181d82ca8","article-title":"The impact of timing of maximal crystalloid hydration on early graft function during kidney transplantation","volume":"110","author":"Othman","year":"2010","journal-title":"Anesth Analg"},{"issue":"4","key":"R18-20250925","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/00007890-198210000-00008","article-title":"Maximal hydration during anesthesia increases pulmonary arterial pressures and improves early function of human renal transplants","volume":"34","author":"Carlier","year":"1982","journal-title":"Transplantation"},{"key":"R19-20250925","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.transproceed.2006.01.072","article-title":"Perioperative fluid management in kidney transplantation: Is volume overload still mandatory for graft function?","volume":"38","author":"De Gasperi","year":"2006","journal-title":"Transplant Proc"},{"key":"R20-20250925","doi-asserted-by":"crossref","first-page":"61","DOI":"10.5500\/wjt.v8.i3.61","article-title":"Utility of central venous pressure measurement in renal transplantation: Is it evidence based?","volume":"8","author":"Aref","year":"2018","journal-title":"World J Transplant"},{"key":"R21-20250925","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1378\/chest.07-2331","article-title":"Does central venous pressure predict fluid responsiveness. A systematic review of the literature and the tale of seven mares?","volume":"134","author":"Marik","year":"2008","journal-title":"Chest"},{"key":"R22-20250925","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s00134-015-4168-4","article-title":"Systematic review including re-analyses of 1148 individual data sets of central venous pressure as a predictor of fluid responsiveness","volume":"42","author":"Eskesen","year":"2016","journal-title":"Intensive Care Med"},{"key":"R23-20250925","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1111\/j.1600-6143.2007.01744.x","article-title":"Recipient hemodynamics during non-heart-beating donor kidney transplantation are major predictors of primary nonfunction","volume":"7","author":"Snoeijs","year":"2007","journal-title":"Am J Transplant"},{"key":"R24-20250925","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1399-0012.1998.tb01007.x","article-title":"Effect of recipients' peri-operative parameters on the outcome of kidney transplantation","volume":"12","author":"T\u00f3th","year":"1998","journal-title":"Clin Transplant"},{"key":"R25-20250925","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13054-017-1928-2","article-title":"Perioperative fluid management in kidney transplantation: A black box","volume":"22","author":"Calixto Fernandes","year":"2018","journal-title":"Crit Care (London, England)"},{"key":"R26-20250925","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4103\/0971-4065.179206","article-title":"Deceased donor renal transplantation: A single center experience","volume":"27","author":"Gopalakrishnan","year":"2017","journal-title":"Indian J Nephrol"},{"key":"R27-20250925","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.transproceed.2011.11.057","article-title":"Delayed graft function in living-donor renal transplantation: 10-year experience","volume":"44","author":"Park","year":"2012","journal-title":"Transplant Proc"},{"key":"R28-20250925","doi-asserted-by":"crossref","first-page":"1689","DOI":"10.1093\/ndt\/gfl042","article-title":"Major effects of delayed graft function and cold ischaemia time on renal allograft survival","volume":"21","author":"Quiroga","year":"2006","journal-title":"Nephrol Dial Transplant"},{"issue":"7 Suppl","key":"R29-20250925","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1097\/TP.0b013e318169c29e","article-title":"Cold ischemia is a major determinant of acute rejection and renal graft survival in the modern era of immunosuppression","volume":"85","author":"Mikhalski","year":"2008","journal-title":"Transplantation"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_334_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:41:28Z","timestamp":1787067688000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_334_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_334_21","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"2021-05-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-08","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}