Ringlar lactate was safe in one kidney patient and other was 100 % wor

Ringlar lactate was safe in one kidney patient and other was 100 % working

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Ringer's lactate safety solitary kidney single functioning kidney IV fluid

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Ringer's lactate (RL, lactated Ringer's) is safe in a patient with one kidney, as long as that kidney's actual function (GFR) is normal or near-normal - which is usually the case with a single kidney from compensatory hypertrophy (nephrectomy, donor, or congenital solitary kidney). What determines safety is overall renal function, not the number of kidneys. A person with one kidney working at essentially normal capacity clears potassium and lactate about as well as someone with two kidneys, so RL behaves the same way in both cases.

Why this is true

RL is a "balanced" crystalloid (less chloride than normal saline, contains lactate that is converted to bicarbonate by the liver and kidneys). It's generally preferred over normal saline because it causes less hyperchloremic acidosis and renal vasoconstriction, and several sources link it to a lower risk of acute kidney injury versus saline - Mulholland and Greenfield's Surgery, Harrison's Principles of Internal Medicine, Miller's Anesthesia.
The main theoretical worry with RL in kidney patients is its potassium content (~4 mEq/L), which raises concern about hyperkalemia when kidney function is genuinely impaired - Mulholland and Greenfield's Surgery, p. block3 (Crystalloids section).
In practice, that worry is often overstated. A retrospective study of patients with reduced kidney function (eGFR <30) found lactated Ringer's did not significantly raise serum potassium compared with normal saline (Rajasekaran et al., Am J Med Sci 2022, PMID 35490704). Similarly, a review of fluid therapy by kidney injury risk noted RL was used safely even in ESRD patients with septic shock.
Balanced solutions like RL are the standard crystalloid of choice for kidney transplantation, specifically because they cause less acidosis and hyperkalemia than normal saline - Barash, Cullen, and Stoelting's Clinical Anesthesia, 9e.

Where caution actually matters

The real dividing line isn't "one kidney vs. two" - it's whether that kidney (or kidneys) has preserved function:

Normal-functioning single kidney (creatinine/eGFR normal, no baseline hyperkalemia): RL is safe, no special restriction needed, same as any patient with normal renal function.
Impaired kidney function (CKD stage 4-5, AKI with oliguria, ESRD, or a solitary kidney that itself has reduced function/baseline hyperkalemia): RL isn't strictly contraindicated, but it's reasonable to check baseline potassium, use moderate volumes, and monitor electrolytes during infusion, rather than avoiding it outright.

So the comparison in your message - "one kidney patient" vs. "other was 100% working" - actually points to the same conclusion: if the remaining kidney's function is essentially normal (equivalent to "100% working" in terms of clearance), RL is safe in both scenarios. The risk only rises if the kidney(s) present have reduced function, regardless of whether there are one or two of them.

If you can clarify the actual clinical context (e.g., was this a transplant/nephrectomy patient, what was the creatinine/eGFR, was there baseline hyperkalemia), I can give a more specific answer.

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