Predictors associated with terminal renal function in deceased organ donors in the intensive care unit.
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.


CONCLUSIONS
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.
Blasi-Ibanez
Annabel
A
Department of Anesthesia and Perioperative Care, University of California San Francisco, California, 94143-0648, USA.
Hirose
Ryutaro
R
Feiner
John
J
Freise
Chris
C
Stock
Peter G
PG
Roberts
John P
JP
Niemann
Claus U
CU
D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003404:Creatinine / Q000652:urine; D003422:Critical Care; D016208:Databases, Factual; D003894:Deamino Arginine Vasopressin / Q000494:pharmacology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007362:Intensive Care Units; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011507:Proteinuria / Q000503:physiopathology; D012076:Renal Agents / Q000494:pharmacology; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D014882:Water-Electrolyte Balance / Q000502:physiology
D001786:Blood Glucose; D012076:Renal Agents; D003404:Creatinine; D003894:Deamino Arginine Vasopressin