BACKGROUND: Factors determining renal function at organ recovery in deceased kidney donors are not well established. METHODS: The authors studied the prevalence and risk factors associated with elevated prerecovery creatinine and calculated glomerular filtration rate in 458 deceased organ donors identified through the California Donor Transplant Network between January 2005 and December 2006. Data collected retrospectively included demographics, medical history, laboratory values, mechanism of death, and medical treatment in the intensive care unit. Factors were analyzed by both univariate and multivariate analysis. RESULTS: There were 260 men and 198 women in the study. The age was 43.2 +/- 14.9 yr, and body mass index was 26.9 +/- 6.0 (mean +/- SD). In multivariate analysis, several factors were important determinants of both prerecovery creatinine and glomerular filtration rate. Admission creatinine or glomerular filtration rate were major determinants of respective prerecovery values (P < 0.0001). Higher body mass index was associated with worse renal function (P < 0.01). Higher average glucose values and greater variability in glucose (when included) were associated with worse prerecovery renal function (P < 0.01). Administration of desmopressin acetate was highly associated with preserved renal function (P < 0.001). Lower platelet count (P < 0.0001) and proteinuria (P = 0.005) were also associated with worse renal function. CONCLUSION: The data identify several important factors that predict renal function at kidney recovery in deceased donors. In particular, tighter control of blood glucose may improve renal function in potential organ donors, but prospective studies are needed to confirm these findings.
BACKGROUND: Factors determining renal function at organ recovery in deceased kidney donors are not well established. METHODS: The authors studied the prevalence and risk factors associated with elevated prerecovery creatinine and calculated glomerular filtration rate in 458 deceased organ donors identified through the California Donor Transplant Network between January 2005 and December 2006. Data collected retrospectively included demographics, medical history, laboratory values, mechanism of death, and medical treatment in the intensive care unit. Factors were analyzed by both univariate and multivariate analysis. RESULTS: There were 260 men and 198 women in the study. The age was 43.2 +/- 14.9 yr, and body mass index was 26.9 +/- 6.0 (mean +/- SD). In multivariate analysis, several factors were important determinants of both prerecovery creatinine and glomerular filtration rate. Admission creatinine or glomerular filtration rate were major determinants of respective prerecovery values (P < 0.0001). Higher body mass index was associated with worse renal function (P < 0.01). Higher average glucose values and greater variability in glucose (when included) were associated with worse prerecovery renal function (P < 0.01). Administration of desmopressin acetate was highly associated with preserved renal function (P < 0.001). Lower platelet count (P < 0.0001) and proteinuria (P = 0.005) were also associated with worse renal function. CONCLUSION: The data identify several important factors that predict renal function at kidney recovery in deceased donors. In particular, tighter control of blood glucose may improve renal function in potential organ donors, but prospective studies are needed to confirm these findings.
Authors: Nancy E Witowski; Elizabeth R Lusczek; Charles E Determan; Daniel R Lexcen; Kristine E Mulier; Andrea Wolf; Beverly G Ostrowski; Greg J Beilman Journal: Mol Biosyst Date: 2016-04-26
Authors: Andrea Olmos; John Feiner; Ryutaro Hirose; Sharon Swain; Annabel Blasi; John P Roberts; Claus U Niemann Journal: Prog Transplant Date: 2015-12 Impact factor: 1.187
Authors: Judith E van Zanden; Henri G D Leuvenink; Erik A M Verschuuren; Zwanida J Veldhuis; Petra J Ottens; Michiel E Erasmus; Maximilia C Hottenrott Journal: Transplant Direct Date: 2021-03-16
Authors: Simey de Lima Lopes Rodrigues; Jose Ben-Hur de Escobar Ferraz Neto; Luiz Antonio da Costa Sardinha; Sebastião Araujo; Helder Jose Lessa Zambelli; Ilka de Fátima Santana Ferreira Boin; Maria Valeria de Omena Athayde; Eliete Bombarda Bachega Montone; Marcia Raquel Panunto Journal: Rev Bras Ter Intensiva Date: 2014 Jan-Mar