Case 3 Pearls

• The fluid of choice of a chronic renal failure is 0.9% saline.
• Hyperkalemia can be a problem and thus a potassium-free fluid is best.
• Simply providing maintenance and deficit volumes may not be enough to initiate a diuresis. 
• Consider either doubling or tripling maintenance requirements and replace deficits in the first 8 hours.
• Careful monitoring is required in renal failure patients.