From the Research
Lactated Ringer's solution can be safely administered in patients with acute renal failure and hyperkalemia, as it does not significantly increase the risk of worsening hyperkalemia, according to a recent study 1. The study found that serum potassium prior to LR use was highly correlated and predictive of the serum potassium after LR use, and that LR use was not independently associated with the development of hyperkalemia in patients with reduced kidney function. Key points to consider when administering LR in these patients include:
- Monitoring serum potassium levels closely before and after LR administration
- Being aware of other potential risk factors for developing hyperkalemia, such as medication, tube feeds, potassium supplements, and red blood cell transfusion
- Having a plan in place to manage hyperkalemia if it develops, such as using insulin with glucose, sodium bicarbonate, calcium gluconate, and potentially dialysis if severe. It's also important to note that normal saline (0.9% NaCl) is still a viable alternative for fluid resuscitation in these patients, as it contains no potassium. However, the study 1 provides evidence that LR can be a safe choice for fluid resuscitation in patients with acute renal failure and hyperkalemia, as long as careful monitoring and management of electrolytes are prioritized.