Balanced crystalloids (lactated Ringer’s solution or Plasma-Lyte A)
Primary outcome: Hospital-free days
Defined as the number of days alive and out of the hospital between the index emergency department visit and 28 days later
Secondary outcomes included
Major adverse kidney events within 30 days | a composite of death from any cause | new renal-replacement therapy | persistent renal dysfunction (defined as an elevation of the creatinine level to ≥200% of baseline)
6708 (50.3%) patients were randomized to balanced crystalloids and 6639 (49.7%) to saline
Median crystalloid volume in the emergency department was 1079 ml
The number of hospital-free days did not differ between the balanced-crystalloids and saline groups
Median was 25 days in each group
Adjusted odds ratio (OR) with balanced crystalloids was 0.98 (95% CI, 0.92 to 1.04; P=0.41)
Use of balanced crystalloids did lower the incidence of major adverse kidney events within 30 days compared to saline
4.7% vs. 5.6%; adjusted OR, 0.82 (95% CI, 0.70 to 0.95; P=0.01)
The administration of crystalloids vs saline did not impact time in hospital but did decrease the rate of adverse kidney events
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