Normal saline and acute kidney injury in hospitalized patients; more precaution to be taken

Abstract

Introduction: Potential nephrotoxic agents are not well recognized and are being used irrespective of patients’ vulnerability. Objectives: We aimed to evaluate the relationship between the prevalence of exposure to normal saline and the risk of hospital acquired acute kidney injury (HA-AKI). Patients and Methods: A retrospective case-control study of a total of 424 hospitalized patients was done. The frequency of exposure to the individual intravenous fluids and their risk of HA-AKI were calculated as odds ratios with 95% confidence interval (CI). Results: Of 424 total sampled hospitalized patients, post-admission normal saline exposure was found in 37.6% in which 22.6% had the development of HA-AKI and 15% did not develop AKI. The risk of HA-AKI was significantly higher in patients who received normal saline and lower in patients who received 5% dextrose water (ORs; 1.92, 95% CI; 1.28, 2.85; P=0.001 and ORs; 0.48, 95% CI; 0.24, 0.95, P=0.02, respectively). Conclusion: Exposure to normal saline was considerably high among hospitalized patients and was associated with a higher risk of AKI. Post-admission administration of high sodium and chloride containing intravenous fluid should be limited in patients who are vulnerable to develop AKI.