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Original Research

Open Access

Changes in potassium level and renal function with balanced crystalloid administration in the emergency department

  • Sungsig Kong1
  • Hyuksool Kwon1,*,
  • Jinhee Lee1
  • Dongbum Suh1

1Department of Emergency Medicine, Seoul National University Bundang Hospital, 13620 Seongnam, Republic of Korea

DOI: 10.22514/sv.2023.022 Vol.19,Issue 5,September 2023 pp.153-160

Submitted: 05 October 2022 Accepted: 01 December 2022

Published: 08 September 2023

*Corresponding Author(s): Hyuksool Kwon E-mail:


A common reason that often makes clinicians hesitate to use balanced crystalloids in the emergency department is the risk of unexpected hyperkalemia in patients with decreased renal function. In this single-center retrospective cohort study, we compared the change in potassium levels before and after administrating a balanced crystalloid, Plasma Solution A, in patients with normal and decreased renal function. Patients who were administered Plasma Solution A and had an electrolyte follow-up potassium test within 24 hours were included. Decreased renal function was defined as an estimated glomerular filtration rate (eGFR) of less than 90 mL/min/1.73 m2. A total of 1134 patients were included, comprising 376 patients with normal renal function (an eGFR >90 mL/min/1.73 m2) and 758 patients with decreased renal function. In patients with decreased renal function, the mean administered Plasma Solution A volume (mL/kg, mean (SD)) was 34.0 (20.1). The mean administration duration (hr, mean (SD)) was 13.9 (4.7). The eGFR (mL/min/1.73 m2, mean (SD)) increased from 52.6 (24.4) to 68.0 (37.6) (p < 0.05), and the potassium level (mmol/L, mean (SD)) decreased from 4.4 (0.6) to 4.1 (0.6) (p < 0.05). Altogether, we found that the potassium level and renal function may not be worsened in patients with decreased renal function within 24 hours after the intravenous administration of approximately 2 L of a balanced crystalloid in the emergency department.


Potassium; Renal function; Balanced crystalloid; Emergency department

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Sungsig Kong,Hyuksool Kwon,Jinhee Lee,Dongbum Suh. Changes in potassium level and renal function with balanced crystalloid administration in the emergency department. Signa Vitae. 2023. 19(5);153-160.


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