Plasma-Lyte vs. Saline: A Draw in the DKA Hydration Duel!

Overview

Paper Summary › Explain Like I'm Five › Conflicts of Interest › Identified Limitations › Rating Explanation › Good to know › Topic Hierarchy › File Information ›

Paper Summary

Paperzilla title

In children with diabetic ketoacidosis (DKA), Plasma-Lyte-A and 0.9% saline showed similar rates of new or progressive acute kidney injury (AKI) and resolution of AKI. No differences were found between the two fluids for time to DKA resolution, need for renal replacement therapy, mortality, or length of ICU/hospital stay.

Explain Like I'm Five

Scientists found that for kids with a special sugar problem (DKA), giving them two different kinds of IV water worked equally well. Both helped their kidneys and made them feel better in the same way.

Possible Conflicts of Interest

None identified

Identified Limitations

Underpowered study

The study is underpowered, as the occurrence of the primary outcome was low in both groups, limiting the ability to draw definitive conclusions.

Single-center study

The single-center design limits the generalizability of the findings to other populations and settings.

Stringent AKI definition

The definition of AKI used in the study was stringent, potentially inflating the incidence of AKI compared to previous studies and clinical practice.

Lack of analysis on clinical significance

The study did not analyze the clinical significance of preventing hyperchloremic acidosis, leaving a gap in understanding the practical implications of using Plasma-Lyte-A.

Limited exploration of dose-related effects

The study did not explore dose-related effects of hyperchloremia, limiting the understanding of fluid volume's impact on AKI.

Rating Explanation

This is the first double-blind randomized controlled trial comparing Plasma-Lyte-A and 0.9% saline in pediatric DKA. The study had a stringent methodology, meticulous monitoring, and near-complete adherence to protocol. Despite being underpowered and limited by its single-center design, it provides valuable insights into fluid management in high-risk DKA patients.

Good to know

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Topic Hierarchy

Domain: Health Sciences

Field: Medicine

Subfield: Nephrology

File Information

Original Title: 0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial

Uploaded: July 14, 2025 at 11:09 AM

Privacy: Public