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Increased serum sodium values in brain-dead donor's influences its long-term kidney function
E Kwiatkowska1, J Bober, K Ciechanowski
1Department of Nephrology, Transplantology and Internal Medicine, Pomeranian University of Medicine Szczecin, Poland. ewakwiat@gmail.com
Transplantation Proceedings
|February 5, 2013
Summary
High sodium levels in brain dead kidney donors negatively impact long-term kidney transplant graft function. This finding highlights the importance of managing donor hypernatremia to improve transplant outcomes.
Area of Science:
- Nephrology
- Transplantation Immunology
- Endocrinology
Background:
- Kidney transplantation in Poland primarily uses brain dead donors, who often have endocrine disorders like diabetes insipidus.
- Donor hypernatremia (high serum sodium) is linked to hypovolemia and increased plasma osmolality, posing risks to transplanted organs.
- The impact of donor hypernatremia on kidney graft function, particularly long-term, requires further investigation.
Purpose of the Study:
- To evaluate the association between donor serum sodium concentration and early and late kidney graft function.
- To determine if donor hypernatremia influences kidney transplant outcomes.
Main Methods:
- Analysis of data from 80 kidney recipients and 54 brain dead donors (2006-2008).
- Correlation analysis between donor serum sodium, creatinine concentrations, and creatinine clearances.
- Comparison of graft function based on donor sodium concentration groups.
Main Results:
- A positive correlation was found between donor serum sodium and creatinine concentrations, and a negative correlation with creatinine clearances.
- Recipients from donors with serum sodium >155 mM showed significantly lower glomerular filtration rates.
- Donor hypernatremia negatively correlated with recipient creatinine clearance at 2, 3, and 4 years post-transplant, confirmed by multivariate analysis.
Conclusions:
- Elevated serum sodium and plasma osmolality in brain dead kidney donors adversely affect long-term graft function.
- This effect is likely mediated by the initiation of inflammatory processes.
- Managing donor hypernatremia may be crucial for improving long-term kidney transplant success.
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