Acute Versus Prolonged Use of Furosemide on Delayed Graft Function in Kidney Transplant Patients

Introduction Delayed graft function in kidney transplant recipients is defined as the need for dialysis within 7 days of transplant and is associated with poor patient outcomes, including acute organ rejection and shortened allograft lifespan. Furosemide has been used with the goal of preventing delayed graft function by decreasing metabolic demand and ischemic injury; however, there is no consensus regarding duration of furosemide use after kidney transplantation. Project Aim To assess the effect of postoperative intravenous furosemide duration on delayed graft function rates in kidney transplant patients. Design This study was a single-center, retrospective chart review of adult patients who received a kidney transplant between January 1, 2021 and June 30, 2023. Included patients were grouped by whether they received furosemide for less than or greater than 48 h post-operatively. The primary outcome was delayed graft function measured by the occurrence of post-transplant dialysis during their hospital stay up to post-operative day 7. Secondary outcomes included the cumulative dose of furosemide within the first 7 days post-transplant and cold ischemic time. Results A total of 200 patients were included in this analysis; 64 in the acute-duration group (<48 h of furosemide) and 136 in the prolonged-duration group (>48 h of furosemide). Four patients (6.3%) in the acute-duration group developed delayed graft function, compared to 53 patients (39.0%) in the prolonged-duration group ( P < .001). Conclusion Kidney transplant patients receiving furosemide for longer than 48 h post-operatively were associated with delayed graft function within 7 days of their transplant.