To the Editor: In a study showing an association between a chloride-liberal fluid administration and kidney injury in critically ill adults, Dr Yunos and colleagues1 acknowledged the potential problems of their study not being blinded or randomized. Nevertheless, we agree that the results justify prudence in prescribing chloride-liberal fluids in this population, especially because alternatives such as lactated Ringer solution are inexpensive and readily available.
Elbers P, Gatz R, Anstey C. Chloride-Restrictive Fluid Administration and Incidence of Acute Kidney Injury. JAMA. 2013;309(6):542–543. doi:10.1001/jama.2012.171511
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