Influence of Hypernatremia and Polyuria of Brain-Dead Donors Before Organ Procurement on Kidney Allograft Function

Abstract

<p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Introduction: </strong>Polyuria and hypernatremia are common problems during the pretransplant care of brain-dead donors. They have not only important role in hemodynamic stability, but also may influence organ transplantation outcomes. The influence of donor hypernatremia in liver transplantation was reported. This study aimed to determine these effects on kidney allograft.</span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Materials and Methods: </strong>We retrospectively studied on 57 transplanted kidney allografts from cadaveric donors.<span style="color: #0070c0;"> </span>The effects of the urine output volume and serum level of sodium of the donors were on the recipients’ serum creatinine levels 1 week after transplantation and at the last follow-up visit were assessed.<span style="text-decoration: underline;"><span style="color: blue;"></span></span></span></span></p><p class="fulltext-textfulltext-indent" style="margin: 0cm 0cm 0pt;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong><span style="mso-bidi-language: FA;">Results:</span></strong><span style="mso-bidi-language: FA;"> </span>Of the donors, 58% had polyuria and 45% had hypernatremia. The median pretransplant urine output of the donors was 130 mL/h (range, 35 mL/h to 450 mL/h), and their mean serum sodium level was 152.0 ± 13.0 <span class="fulltext-it">mEq/L</span>. Serum creatinine concentrations in the recipients at the 1st posttransplant week correlated significantly <span style="mso-bidi-language: FA;">with</span> <span style="mso-bidi-language: FA;">the recipients’ age (r = 0.355, <em>P</em> = .02) and the donors’ urine output volume (r = 0.329, <em>P</em> = .04).</span> <span style="mso-bidi-language: FA;">The serum creatinine measured in the last follow-up visit significantly correlated only with the donors’ serum sodium levels (r = 0.316, <em>P</em> = .02) and the donors’ age (r = 0.306, <em>P</em> = .02). Multivariate regression analysis showed that the donors’ serum levels of sodium and potassium were the predictors of the last measured serum creatinine level. </span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; direction: ltr; unicode-bidi: embed; text-align: left;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Conclusion:</strong> Polyuria and hypernatremia in brain-dead donors are frequent. Elevated serum level of sodium and polyuria in the donor can have adverse effects on kidney allograft function. </span></span></p>