TY - JOUR
T1 - Fluid overload and renal function in children after living-donor renal transplantation
T2 - a single-center retrospective analysis
AU - Porn-Feldman, Hagit
AU - Davidovits, Miriam
AU - Nahum, Elhanan
AU - Weissbach, Avichai
AU - Kaplan, Eytan
AU - Kadmon, Gili
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Background: We aimed to compare renal function after kidney transplantation in children who were treated with higher vs. lower fluid volumes. Methods: A retrospective analysis of 81 living-donor renal transplantation pediatric patients was performed between the years 2007 and 2018. We analyzed associations of the decrease in serum creatinine (delta creatinine) with fluid balance, central venous pressure (CVP), pulmonary congestion, mean arterial pressure (MAP), and MAP-CVP percentiles in the first 3 postoperative days. After correcting creatinine for fluid overload, we also assessed associations of these variables with the above parameters. Finally, we evaluated the association between delta creatinine and estimated glomerular filtration rate (eGFR) at 3 months follow-up. Results: Both delta creatinine and delta-corrected creatinine were found to be associated with pulmonary congestion on the second and third postoperative days (p < 0.02). In addition, trends for positive correlations were found of delta creatinine with fluid balance/kg (p = 0.07), and of delta-corrected creatinine with fluid balance/kg and CVP (p = 0.06–0.07) on the second postoperative day. An association was also demonstrated between the accumulated fluid balance of the first 2 days and eGFR at 3 months after transplantation (p = 0.03). Conclusions: An association was demonstrated between indices of fluid overload, >80 ml/kg, and greater improvement in renal function. Impact: There is no consensus regarding the optimal fluid treatment after pediatric renal transplantation.In our cohort, indices of fluid overload were associated with better renal function immediately after the transplantation and 3 months thereafter.Fluid overload after living-donor renal transplantation in children may have short- and long-term benefits on renal function.
AB - Background: We aimed to compare renal function after kidney transplantation in children who were treated with higher vs. lower fluid volumes. Methods: A retrospective analysis of 81 living-donor renal transplantation pediatric patients was performed between the years 2007 and 2018. We analyzed associations of the decrease in serum creatinine (delta creatinine) with fluid balance, central venous pressure (CVP), pulmonary congestion, mean arterial pressure (MAP), and MAP-CVP percentiles in the first 3 postoperative days. After correcting creatinine for fluid overload, we also assessed associations of these variables with the above parameters. Finally, we evaluated the association between delta creatinine and estimated glomerular filtration rate (eGFR) at 3 months follow-up. Results: Both delta creatinine and delta-corrected creatinine were found to be associated with pulmonary congestion on the second and third postoperative days (p < 0.02). In addition, trends for positive correlations were found of delta creatinine with fluid balance/kg (p = 0.07), and of delta-corrected creatinine with fluid balance/kg and CVP (p = 0.06–0.07) on the second postoperative day. An association was also demonstrated between the accumulated fluid balance of the first 2 days and eGFR at 3 months after transplantation (p = 0.03). Conclusions: An association was demonstrated between indices of fluid overload, >80 ml/kg, and greater improvement in renal function. Impact: There is no consensus regarding the optimal fluid treatment after pediatric renal transplantation.In our cohort, indices of fluid overload were associated with better renal function immediately after the transplantation and 3 months thereafter.Fluid overload after living-donor renal transplantation in children may have short- and long-term benefits on renal function.
UR - http://www.scopus.com/inward/record.url?scp=85100114844&partnerID=8YFLogxK
U2 - 10.1038/s41390-020-01330-4
DO - 10.1038/s41390-020-01330-4
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C2 - 33432156
AN - SCOPUS:85100114844
SN - 0031-3998
VL - 90
SP - 625
EP - 631
JO - Pediatric Research
JF - Pediatric Research
IS - 3
ER -