Role of renal venous oxygen pressure for renal function monitoring after related living-donor kidney transplantation: cohort study

Abstract

IntroductionMonitoring of renal function after kidney transplantation (KT) is performed by measuring serum creatinine (SCr), urine volumes (UV), and glomerular filtration rate (GFR). Other methods based on oxygen metabolism such as the renal venous oxygen pressure (PrvO2) may be useful. We aimed to explore the correlation between PrvO2and SCr, UV, and GFR five days after KT (SCr5, UV5, and GFR5, respectively).MethodsWe conducted a prospective cohort study in adult patients scheduled for living-donor KT. A venous blood sample was taken from the renal vein after declamping the renal artery and blood gas determinations were made. Correlation analyses between PrvO2and SCr5, UV5, and GFR5, were done by calculating the Spearman correlation coefficient together with generalized linear models (GLM). A Spearman correlation analysis was performed between the percentage decrease in SCr (%ΔSCr) and PrvO2. A GLM was also performed to determine the association of PrvO2with slow graft function (SGF).Results42 patients were included; 66.7% were men, and the median age was 31 years (IQR: 27-43.5). PrvO2was negatively correlated with SCr5 (ρ=-0.53, p=0.003), and positively correlated with GFR5 (ρ=0.49, p=0.001) and %ΔSCr (ρ=0.47, p=0.002). A higher PrvO2was associated with an increase in GFR in univariable (β=1.24, 95%CI: 0.56-1.93, p=0.001) and multivariable (β=1.24, 95%CI: 0.53-1.94, p=0.001) analyses. No association was found between PrvO2and SGF.ConclusionPrvO2could be used to monitor renal function in the first 5 days following related living-donor KT given its good correlation with SCr and GFR.