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February 13, 2013

Chloride-Restrictive Fluid Administration and Incidence of Acute Kidney Injury—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Johor Bahru Clinical School, Monash University Sunway Campus, Malaysia (Dr Yunos); Australia and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia (Drs Bellomo and Bailey) (rinaldo.bellomo@austin.org.au).

JAMA. 2013;309(6):543-544. doi:10.1001/jama.2012.171514

In Reply: Dr Albert is concerned that the renal changes we observed could be explained by differences in sodium administration. He highlights the apparent discrepancy between the sodium received by the entire cohort vs the nested cohort. However, the sodium received by the entire cohort was the mean value, whereas the median value was presented for the nested cohort. In these 100 patients, the mean amount of sodium received per patient during the control period was 473 mmol (95% CI, 366-580 mmol) compared with 433 mmol (95% CI, 351-515 mmol) during the intervention period (P = .55); the respective values for the whole cohort were 750 mmol and 623 mmol.