Hydration status of patients with end-stage renal disease after kidney transplantation

Clin Transplant. 2011 Nov-Dec;25(6):E656-63. doi: 10.1111/j.1399-0012.2011.01496.x. Epub 2011 Aug 24.

Abstract

Background: This study was carried out to estimate the modification of hydration status within the first three months of renal transplantation.

Subjects and methods: Fifty patients who underwent a first kidney allograft were prospectively followed for three months after renal transplantation to assess hydration status by bioimpedance spectroscopy.

Results: Two hours before the transplant procedure, 10/42 (23.8%) patients were overhydrated. Two days after surgery, 32/40 (80.0%) patients were overhydrated and at three months, 14/27 (51.9%) patients remained fluid-overloaded. Peritoneal dialysis (PD) patients had a lower hydration status (-0.60 L) than hemodialysis (HD) patients (0.70 L; p < 0.05) and better residual diuresis (41.7 vs. 8.3 mL/h for HD patients, p < 0.01). Compared with patients who had a delayed graft function (DGF) or a slow graft function (SGF), the immediate graft function (IGF) group had a better hydration status before transplantation (p = 0.031). At three months, 12/14 of the overhydrated patients had a creatinine clearance between 30 and 60 mL/min/1.73 m(2) .

Conclusion: Patients receiving a first kidney transplant frequently have a hydration disorder. Transplantation is associated with increased hydration status, which seems to persist if DGF or SGF occurs.

MeSH terms

  • Adult
  • Body Water / physiology*
  • Creatinine / metabolism
  • Delayed Graft Function*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Rejection*
  • Graft Survival / physiology
  • Humans
  • Kidney Failure, Chronic / physiopathology*
  • Kidney Failure, Chronic / therapy*
  • Kidney Function Tests
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Renal Dialysis
  • Risk Factors

Substances

  • Creatinine