Magnesium: not essential for renal preservations by initial perfusion and hypothermic storage

Area of Science:

• Nephrology
• Transplantation
• Organ Preservation

Background:

• Divalent magnesium ions are often included in synthetic preservation media for hypothermic renal preservation.
• Previous studies presumed magnesium's necessity based on experimental observations.
• Potential precipitation of magnesium salts in perfusates raises questions about its inclusion.

Purpose of the Study:

• To investigate the necessity of magnesium chloride in hyperosmolar intracellular electrolyte solutions for renal preservation.
• To evaluate the impact of omitting magnesium on canine kidney function after prolonged preservation.

Main Methods:

• Retrospective analysis of existing data on magnesium's role.
• Experimental omission of magnesium chloride from hyperosmolar perfusates.
• Assessment of canine kidney function after 2 and 3 days of perfusion and storage.

Main Results:

• Canine kidneys preserved without magnesium chloride showed no adverse effects on ultimate renal function.
• Prolonged preservation (2-3 days) was successful even with magnesium omission.
• The absolute necessity of magnesium for successful renal preservation is questioned.

Conclusions:

• Magnesium chloride is not an absolute requirement for effective hypothermic renal preservation.
• Hyperosmolar intracellular electrolyte solutions lacking magnesium chloride can support successful canine kidney preservation.
• This challenges the long-held assumption of magnesium's essentiality in renal preservation media.