Effects of tight versus non tight control of metabolic acidosis on early renal function after kidney transplantation

120 patients were randomly divided into two equal groups. In group A, bicarbonate was infused intra-operatively according to Base Excess (BE) measurements to achieve the normal values of BE (？5 to +5？mEq/L). In group B, infusion of bicarbonate was allowed only in case of severe metabolic acidosis (BE？≤？？15？mEq/L or bicarbonate？≤？10？mEq/L or PH？≤？7.15). Minute ventilation was adjusted to keep PaCO2 within the normal range. Primary end-point was sampling of serum creatinine level in first, second, third and seventh post-operative days for statistical comparison between groups. Secondary objectives were comparison of cumulative urine volumes in the first 24？h of post-operative period and serum BUN levels which were obtained in first, second, third and seventh post-operative days.In group A, all of consecutive serum creatinine levels were significantly lower in comparison with group B. With regard to secondary outcomes, no significant difference between groups was observed.Intra-operative tight control of metabolic acidosis by infusion of Sodium Bicarbonate in renal transplant recipients may improve early post-operative renal function.Kidney transplantation is a cardinal method and the most cost-effective treatment modality used for the patients with chronic renal failure (CRF) [1].Experiments in animals show that premedication with Sodium Bicarbonate, before the development of ischemic damage in renal tubules, may have renoprotective effects [2,3]. It is obvious that transplanted kidney is under the risk of ischemic insult (warm and cold ischemic period).Furthermore, Infusion of sodium bicarbonate solution (8.4%), which is hyperosmolar, can shift intracellular water into interstitial and intravascular spaces leading to intravascular volume expansion and induces osmotic diuresis [4-6]. Meanwhile, the alkalization of the urine might increase the solubility of acidic materials accumulated in CRF patients and enhance their excretion through urine [7]. The main concern with