Fewer Adverse Renal Events with Balanced Crystalloids versus Saline

Restricted access

In both critically ill and non-critically ill adults, balanced crystalloids are associated with a lower risk of adverse renal events compared to saline, according to a pair of trials in The New England Journal of Medicine.

The “Saline Against Lactated Ringer’s or Plasma-Lyte in the Emergency Department” (SALT-ED) study included 13,347 adult patients seen in the emergency department (ED) and subsequently hospitalized outside the ICU. Over 16 months, the ED crossed-over monthly from treatment using balanced crystalloids (lactated Ringer’s solution or Plasma-Lyte A). Median volume of crystalloids administered in the ED was 1079 mL; about 88% of patients