신이식 환자에서 생리식염수와 하트만 용액이 전해질과 산염기 및 신기능에 미치는 영향

Abstract

Background: The purpose of this study was to elucidate the effects of fluid on the acid–base and electrolytes status and renal function after kidney transplantation (KT). Methods: We retrospectively analyzed 103 patients who underwent KT. Analyses were performed separately according to the donor type (living, 52; deceased, 51). In the living donor KT group, 28 patients received normal saline solution (NS) and 24 patients received Hartmann’s solution (HS). In the deceased donor KT group, 27 patients received NS, and 24 received HS. The acid–base and electrolyte status, urine volume, and renal function between patients receiving NS and patients receiving HS were compared in each group. Results: Regardless of donor type, there were no differences in potassium, pH, base excess, PCO2 and HCO3 between HS and NS on immediate postoperative and postoperative day 1. However, changes to neutral acid-base balance in terms of pH, HCO3, and base excess were significantly higher in HS than in NS. In living donor KT, NS increased serum potassium and chloride significantly during fluid therapy. On postoperative day 7, renal function showed no difference between two groups but urine volume was significantly larger in NS than in HS. Conclusions: HS does not increase the incidence of hyperkalemia after KT. The use of HS resulted in less metabolic acidosis than the use of NS. Renal function was similar but polyuria was more severe in patients who received NS than in those who received HS.