Diuretic Use in Post-Kidney Transplant Patients: A Retrospective Chart Review.

Autor: Ghozloujeh ZG; Department of Medicine, Division of Nephrology, Loma Linda University School of Medicine, Loma Linda, California., Jang SM; Soo Min Jang, PharmD, Proacture Consulting Group, Bloomfield Hills, Michigan., Abdipour A; Department of Medicine, Division of Nephrology, Loma Linda University School of Medicine, Loma Linda, California. Electronic address: aabdipou@llu.edu.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2024 Jan-Feb; Vol. 56 (1), pp. 82-86. Date of Electronic Publication: 2024 Jan 10.
DOI: 10.1016/j.transproceed.2023.11.024
Abstrakt: Background: The occurrence of delayed graft function (DGF) significantly enhances the possibility of both acute and chronic rejection of the transplanted organ, thereby reducing patient quality of life and survival rates. To prevent and manage oliguria in renal transplant patients, loop diuretics are presently commonly used. In our study, we assessed the possible impact of furosemide on the incidence of DGF among kidney transplant recipients.
Methods: A review of medical records was conducted to examine demographic characteristics and kidney transplant outcomes in an adult (older than 18 years old) population. The primary objective was to determine the incidence of delayed graft function (DGF), whereas the secondary objective was to compare the creatinine levels and estimated glomerular filtration rate (eGFR) at day 30 and day 90 post-transplantation in patients who were administered furosemide vs those who were not.
Results: This study included 330 patients who underwent kidney transplantation. Furosemide was administered to 169 (51.3%), whereas 161(48.7%) patients did not receive continued dose of diuretic postoperatively. The rate of DGF was significantly higher in patients who received furosemide than in those who did not (furosemide 44% vs 4%; P < .001). The eGFR was lower in the furosemide group compared to the no furosemide group at day 30 (56 ± 24 vs 71 ± 24 mL/min/1.73 m 2 , P < .001) and day 90 (66 ± 27 vs 78 ± 25 mL/min/1.73 m 2 , P < .001).
Conclusions: Our results show that there is no benefit in treating an oliguric AKI with furosemide. Administration of furosemide, especially in high doses, may increase the risk of toxicity, delay dialysis, and increase the length of stay.
Competing Interests: Declaration of competing interest All the authors declare no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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