Maintenance of kidney function in donors with rhabdomyolysis and acute renal failure

Abstract

Objective To explore the methods of maintenance of kidney function in donors with rhabdomyolysis and acute renal failure (ARF). Methods Kidney donors with ARF caused by rhabdomyolysis and the methods of donor maintenance from January 2012 to December 2016 were retrospectively reviewed. The routine maintenance methods include hemodynamic treatment, correcting hypoxia and stabilizing the balance of fluids and electrolytes. The specific strategies of rhabdomyolysis and ARF include volume expansion, urinary alkalinization, plasmapheresis and renal replacement therapy (RRT). Results Fifteen donors suffered from rhabdomyolysis and ARF were enrolled in the present study. The peak level of creatinine kinase serum myoblobin and serum creatinine were (15 569±8597) U/L, (37 092±42 100) μg/L and (422±167) μmol/L, respectively. Three donors received plasmapheresis therapy (1-2 sessions), 2 donors received RRT and 1 donor received extra-corporeal membrane oxygenation treatment. Kidneys from these donors were transplanted into 30 recipients, among which delayed graft function was found in 6 patients. With a follow-up to 15-48 months, all patients and renal grafts survived. The mean of glomerular filtration rate were (68.1±15.3) and (70.3±14.6) ml/ (min•1.73 m2), respectively at 12 and 24 month after transplantation. Conclusion Kidneys donors with ARF and rhabdomyolysis had an excellent short-term outcome after appropriate maintenance. Key words: Acute kidney injury; Rhabdomyolysis; Kidney transplantation