Incidence and Treatment of Arginine Vasopressin Deficiency (Central Diabetes Insipidus) in the Setting of Brain Death and Associations with Renal Function and Hemodynamics in Organ Donors

被引：0

作者：

Weiss, Marleen ^{[1
,2
]}

Ruecker, Fabian ^{[1
]}

Thieme, Volker ^{[1
]}

Hochmuth, Karsten ^{[3
]}

Michalski, Dominik ^{[4
]}

Nashan, Bjoern ^{[5
]}

Tautenhahn, Hans-Michael ^{[6
]}

Werdehausen, Robert ^{[2
]}

Ziganshyna, Svitlana ^{[7
]}

机构：

[1] Univ Leipzig, Med Ctr, Med Fac, Dept Anesthesiol & Intens Care Med, D-04103 Leipzig, Germany

[2] UNIV MAGDEBURG, Med Fac, Dept Anesthesiol & Intens Care Med, D-39120 MAGDEBURG, Germany

[3] German Organ Procurement Org DSO, D-04157 Leipzig, Germany

[4] Univ Leipzig, Dept Neurol, Med Ctr, D-04103 Leipzig, Germany

[5] Univ Sci & Technol China, Affiliated Hosp 1, Dept Organ Transplantat Ctr, Hefei 230001, Peoples R China

[6] Univ Leipzig, Dept Visceral Transplantat Thorac & Vasc Surg, Med Ctr, D-04103 Leipzig, Germany

[7] Univ Leipzig, Med Ctr, Med Fac, Organ Donat Coordinator Unit, D-04103 Leipzig, Germany

来源：

JOURNAL OF CLINICAL MEDICINE | 2024年 / 13卷 / 23期

关键词：

organ protection; central diabetes insipidus (CDI); arginine vasopressin deficiency (AVP-D); desmopressin; acute kidney injury; transplantation; donors; brain death; DESMOPRESSIN; PROCUREMENT; MANAGEMENT;

D O I：

10.3390/jcm13237073

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background/Objectives: Arginine vasopressin deficiency (AVP-D) is a common condition in the setting of brain death. The aim of this study was to analyze the frequency of AVP-D in organ donors, its treatment, as well as the impact of AVP-D on hemodynamics and renal function. Methods: This single-center, retrospective study included 63 organ donors treated between 2017 and 2022. We used standard criteria to examine the incidence of AVP-D and the KDIGO criteria to determine the rate of acute kidney injury (AKI). Results: AVP-D occurred in 79% of the examined organ donors, of which 94% received desmopressin. Overall, 30% of organ donors developed AKI. AKI was present in 77% of donors who did not meet AVP-D criteria and in only 18% of donors with AVP-D (p < 0.001). Mean arterial blood pressure did not differ between organ donors with and without AVP-D or with and without desmopressin therapy. In organ donors with AVP-D, norepinephrine requirement in the period 24 h prior to AVP-D diagnosis was lower than 24 h afterwards (p = 0.03). AVP-D diagnosis was associated with a higher rate of kidney transplantation compared to cases without AVP-D diagnosis (88% vs. 54%, p = 0.01). Conclusions: AVP-D is common among brain death organ donors and may remain undiagnosed in cases with previous kidney injury. These observations highlight the importance of recognizing AVP-D and administering appropriate therapy in potential organ donors to prevent AKI.

引用

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