title: Increased serum sodium values in brain-dead donor's influences its long-term kidney function.
abstract: BACKGROUND
  Kidney transplantation in Poland predominantly (95%) involves brain dead donors that display associated endocrine disorders. Diabetes insipidus, the most common complication, results in hypernatremia, hypovolemia, and increased plasma osmolality. Hypernatremia in donors is one of the strongest risk factors for the loss of a transplanted liver or heart. However, the influence of donor hypernatremia on early and late kidney graft function has not been entirely established to date.
  
  
  RESULTS
  We analyzed data for 80 kidney recipients from 54 brain dead donors during 2006-2008. Donors showed a positive correlation between serum sodium and creatinine concentrations (P = .001) and a negative correlation between serum sodium concentrations and creatinine clearances (P < .005). Donors divided into two groups based on a median sodium concentration of 155 mM revealed significantly lower values of glomerular filtration rate in recipients of the group with sodium concentrations >155 mM.
  
  
  RESULTS
  No relationship was observed between donor serum sodium concentration and early or 1-year function. There was a negative correlation between donors serum sodium concentration and creatinine clearance in recipients at 2, 3, and 4 years after kidney transplantation (P = .008, .00033, and .02, respectively). Multivariate analysis confirmed the influence of donor sodium concentration on creatinine clearance at 2 and 3 years after renal transplantation (P < .05 and P > .01, respectively).
  
  
  CONCLUSIONS
  High serum sodium concentrations and increased plasma osmolality in brain dead kidney donors adversely affect long-term graft function probably due to initiation of an inflammation processes.
authors: Department of Nephrology, Transplantology and Internal Medicine, Pomeranian University of Medicine Szczecin, Poland. ewakwiat@gmail.com
authors: E
authors: E
authors: Kwiatkowska
authors: J
authors: J
authors: Bober
authors: K
authors: K
authors: Ciechanowski
authors: K
authors: K
authors: Kȩdzierska
authors: E
authors: E
authors: Gołmbiewska
mesh_terms: D000328:Adult; D001926:Brain Death / Q000503:physiopathology*; D003404:Creatinine / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006955:Hypernatremia / Q000378:metabolism; D007249:Inflammation / Q000473:pathology*; D007668:Kidney / Q000473:pathology*; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009994:Osmolar Concentration; D011044:Poland; D051437:Renal Insufficiency / Q000601:surgery*; D012307:Risk Factors; D012964:Sodium / Q000097:blood*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D012964:Sodium; D003404:Creatinine