Effects of different methods of diuresis on renal function of patients receiving kidney transplantation: a randomized, controlled, double-blind trial

ABSTRACT

A number of pharmacological methods are being used for preserving the function of the transplanted kidney; however, their effects on the future performance of these kidneys remain controversial. We aimed to compare the effects of different methods of induced diuresis on the function of transplanted kidneys. This randomized, controlled, double-blind trial was conducted among 140 candidates of renal transplantation. They were randomly assigned into four equal groups of 35 patients each control group [receiving furosemide and mannitol], group receiving dopamine, group receiving aminophylline, and group receiving a hyperosmolar solution containing dextrose and sodium bicarbonate [forced diuresis group]. To assess renal function, urine volume, creatinine clearance, urinary sodium excretion, and serum creatinine were measured. Data were analyzed using SPSS software. Pearson correlation and analysis of variance [ANOVA] tests were used as appropriate. Age and gender distribution of kidney graft recipients and donors of transplanted kidneys had no statistically significant difference among the four studied groups. During the first postoperative day, creatinine clearance was significantly higher in the groups receiving either dopamine or forced diuresis compared with other groups. Likewise, in the first 2 hours after surgery the mean urinary output and creatinine clearance were significantly higher in the groups receiving either dopamine or forced diuresis. The stimulation of transplanted kidneys by dopamine and using forced diuresis were the best methods in increasing the surrogate markers of renal function, i.e. urinary output, and creatinine clearance. They may be suggested as methods of choice for supporting the function of transplanted kidneys