The effect of mannitol on kidney function after kidney transplantation: a systematic review and meta-analysis

S.C. van de Laar, G.N. Schouten, J.N.M. IJzermans, R.C. Minnee

Wednesday 4 march 2020

14:30 - 14:40h at Leo Franssen zaal

Parallel session: Parallel sessie V – Donatie en Verpleegkundige abstracts

Background: The effect of mannitol usage during kidney donation and kidney transplantation is still unclear. Therefore, we performed a systematic review and meta-analysis to investigate difference in graft function between kidney grafts treated with and without mannitol.

Methods:  A literature search was performed in five databases on the 6^th of March 2019 and included seven eligible studies out of 3112 references. Relevant outcomes for meta-analysis were graft survival, acute tubular necrosis, delayed graft function, renal failure ,and serum creatinine. The quality of evidence was assessed using the Newcastle-Ottawa scale and Jadad score.

Results: Seven studies were identified, one study examining the effect of mannitol during kidney donation and six studies during kidney transplantation. Six studies were eligible for the meta-analysis. The risk of acute tubular necrosis, delayed graft function and renal failure was RR=1.22, 95% CI [0.84, 1.77], P = 0.31, RR=1.39, 95% CI [0.85, 2.28], P =0.19, RR=2.34, 95% CI [0.94, 5.85], P = 0.07 respectively. Graft survival showed a trend for Mannitol, but was not eligible for meta-analysis.

Conclusions: This systematic review and the meta-analysis do not provide evidence to use mannitol during kidney donation and kidney transplantation to significantly improve graft function.