Ringer's lactate solution contains which concentration of potassium, and this is the reason it should be used with caution in patients with which condition?

• A Potassium 4 mEq/L; caution in chronic kidney disease because of potassium accumulation ✓
• B Potassium 2 mEq/L; caution in chronic kidney disease because of potassium accumulation
• C Potassium 4 mEq/L; caution in severe hepatic failure because lactate cannot be metabolised
• D Potassium 5 mEq/L; caution in heart failure because of the sodium load

Explanation

Ringer's lactate contains potassium 4 mEq/L, calcium 3 mEq/L and sodium 130 mEq/L with lactate 28 mEq/L as the buffer. In chronic kidney disease the fixed potassium load can accumulate and cause hyperkalaemia, so it is used cautiously. Hepatic failure impairs lactate-to-bicarbonate conversion, but the classical caution attached to the 4 mEq/L potassium content is renal impairment, making option A the standard textbook pairing.

Reference: Miller's Anesthesia, 9th ed.

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