Assessment of the dialysis methods according to operative parameters for the patients with renal transplantation

Because of the growing number of the patient population with renal transplantation, pronlation of the transplant kidneys life has become the one of the main purpose for most part of the medical staff especially doctors. In this study, we evaluated comparasion of the intraoperative acid-base chagements and post-operative early renal function between dialysis methods. We enrolled 237 patients in this study who having made renal transplantation by Transplantation Clinic of Akdeniz University Hospital since January, 2010. Patients files were analysed retrospectively. We excluded the 492 of the 729 patients who having made renal transplantation since January 2010, 155 of the 492 patients because of the cadaveric transplantations, 44 of the 492 patients because of the age was under the 18, and 293 of the 492 patients because of the absence of the intraoperatively blood gases tests result. The demographical datas of the patients (ages and genders), the cause of the chronical renal failure, status of the dialysis, the state of being preemptive, type of dialysis (haemodialysis or peritoneal dialysis) were recorded. Patients intraoperatively blood gases tests results (respetively; pH, PaCO2, PaO2, glucose, lactate and NaHCO3) were recorded. Preoperative, intraoperative and postoperative, pulse, systolic blood pressure, diastolic blood pressure and CVP measurements were recorded. Also preoperatively BUN, creatinine, haemoglobin, natrium, potassium, calcium and phosphor measurement and postoperatively, BUN, creatinine, haemoglobin, natrium, potassium and calcium measurements were recorded. Patients were divided inte three groups, haemodialysis group, preempitive group and peritone dialysis group. We aimed this study that, effects of the blood gasses tests results contain pH, lactate and glucose to the renal perfusion and renal functions postoperatively. The statistical analysis showed that, pH measurements significantly lower for preemptive group than haemodilysis and peritone dialysis groups (p<0,05) but there were no differences between haemodialysis and peritone dialysis groups. Lactate measurements were significantly higher in haemodialysis groups than preemtive groups (p<0,05). There were no differences for glucose measurements between hamodialysis, preemptive and peritone dialysis. The results of the tests supported our clinical foresight. There was a significant negative correlation between the pH measurements and lactate, paCO2, preoperative BUN, postoperative BUN, preoperative haemoglobin, preoperative potassium measurements (p<0,05). There was a significant positive correlation between, pH measurements and PaO2, HCO3, intraoperative CVP measurements (p<0,05). There was a significiant positive correlation between lactate measurements and PaCO2, post operative BUN, post operative creatinine measurements (p<0,05). There was a significant negative correlation between, glucose measurements and lactate or pH measurements and there was a significant positive correlations between glucose measurements and PaCO2, PaO2, postoperative BUN, preoperative creatinine measurements (p<0,05). This results showed that, intraoperatively metabolic conditions can effect the postoperatively renal functions. The existing of intraoperatively metabolic acidosis, elevation of lactate and glucose levels can caused by the elevation of the serum BUN and creatinine levels postoperatively. Consequently, intraoperative period is very important for postoperatively renal functions and prolongation of the grafts life. While following the whole renal transplant patients especially preemptive groups some parameters should be considered and monitored carefully include regular and blood gasses tests, interfering the metabolic acidosis, haemodinammicaly instability