IJOTM 2008-6490 8 1 2017 01 11 The Effect of Osmotherapy and Tight Control of Acidosis on Early Graft Function among Deceased- Donor Kidney Transplant Recipients: A Randomized Controlled Trial 8 16 EN F Etezadi AH Najafi Abrandabadi J Motaharinia Department of Pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. motahariniaj@gmail.com M Mojtahedzadeh P Pourfakhr MR Khajavi S Gooran R Shariat Moharari S Dehghani 2016 02 13 2016 05 12 Background: Reperfusion injury and the acid-base status of the transplant are important factors affecting post-transplantation graft function.Objective: We hypothesized that infusing hypertonic saline (HS) or tight control of acid-base status of the blood rushing through renal graft using sodium bicarbonate may have beneficial effects on early graft function.Methods: Candidates for deceased-donor kidney transplant were randomized into three groups. HS group (n=33) received 50 mL/kg normal saline (NS) titrated during operation plus 4 mL/kg of 5% HS just within graft reperfusion phase; bicarbonate group (n=37) was administered 60 mL/kg NS while their metabolic acidosis (base excess ≤‑5 mEq/L) was tightly corrected every 30 min with sodium bicarbonate; and a control group (n=36) that received 60 mL/kg normal saline while they were administered sodium bicarbonate only, if they encountered severe metabolic acidosis (base excess ≤‑15 mEq/L). The primary outcome was defined as early post-operative renal function evaluated based on serial serum creatinine levels. The study was registered in Iranian Registry of Clinical Trials (IRCT2013122815841N19).Results: Post-operative early graft function improved significantly during the first 3 days in the intervention groups (p<0.05). However, that beneficial effect no longer remained at the same level after the day four.Conclusion: Timely administration of HS or tight control of metabolic acidosis with sodium bicarbonate infusion improve early renal function during renal transplant surgery.