The use of mannitol in partial and live donor nephrectomy: an international survey
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Animal studies have shown the potential benefits of mannitol as renoprotective during warm ischemia; it may have antioxidant and anti-inflammatory properties and is sometimes used during partial nephrectomy (PN) and live donor nephrectomy (LDN). Despite this, a prospective study on mannitol has never been performed. The aim of this study is to document patterns of mannitol use during PN and LDN.
Materials and methods
A survey on the use of mannitol during PN and LDN was sent to 92 high surgical volume urological centers. Questions included use of mannitol, indications for use, physician responsible for administration, dosage, timing and other renoprotective measures.
Mannitol was used in 78 and 64 % of centers performing PN and LDN, respectively. The indication for use was as antioxidant (21 %), as diuretic (5 %) and as a combination of the two (74 %). For PN, the most common dosages were 12.5 g (30 %) and 25 g (49 %). For LDN, the most common doses were 12.5 g (36.3 %) and 25 g (63.7 %). Overall, 83 % of centers utilized mannitol, and two (percent or centers??) utilized furosemide for renoprotection.
A large majority of high-volume centers performing PN and LDN use mannitol for renoprotection. Since there are no data proving its value nor standardized indication and usage, this survey may provide information for a randomized prospective study.
KeywordsMannitol Live donor nephrectomy Partial nephrectomy Renoprotective agent Diuretics
To, Guazzoni G. (Department of Urology, San Raffaele Hospital, Milan Italy), Schips L. (Department of Urology, S.Pio da Pietrelcina Hospital, Vasto, Italy), Harper J (University of Washington Seattle, USA), Romanò A.L. (Department of Urology, Ospedale Luigi Sacco, Milan, Italy), Chun F.K. (Department of Urology, University of Hamburg, Germany), Sulser T. (Clinic for Urology, University Hospital, Zurich, Switzerland), Klinkl M. (Department of Urology, Medical University Vienna, Vienna, Austria), Kavoussi L. (Long Island, NY, USA), Joyce A. (St James’ University Hospital, Leeds, UK), Lucan M. (Clinical Institute of Urology and Renal Transplantation Cluj- Napoca, Romania), Leike S. (Klink und Poliklinik für Urologie Dresden, Germany) and Porena M. (Department of Medical Surgical Specialties and Public Health, Section of Urology and Andrology, Università di Perugia, Italy), Sabaté S. and Vernetta D. (Department of Anaesthesiology, Fundaciò Puigvert, Barcelona, Spain for their contribution to this survey.