{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:40:24Z","timestamp":1787071224991,"version":"build-2736575974"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>End-stage renal disease (ESRD) necessitates renal transplantation, where precise fluid management is essential for graft perfusion and function. Central venous pressure (CVP) is traditionally used, but the optimal strategy is uncertain. Pulse pressure variation (PPV), a dynamic index, may better predict fluid responsiveness. This randomized trial compared PPV- versus CVP-guided fluid therapy in kidney transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Fifty ESRD patients undergoing renal transplantation were randomly divided into two groups (n = 25 each). Group A received intraoperative fluid therapy guided by PPV, while Group B followed CVP-guided fluid therapy. The primary outcome was total intraoperative fluid administered. Secondary outcomes included total urine output, time to onset of diuresis, incidence of hypotensive episodes, and post-reperfusion lactate levels. Data were analyzed with independent t-tests or Mann\u2013Whitney tests for continuous variables and Fisher\u2019s exact test for categorical variables;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05 denoted significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Total fluid administration was significantly lower in the PPV group (1862 \u00b1 327 mL) than in the CVP group (2480 \u00b1 355 mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). Intraoperative urine output was higher with PPV guidance (996 \u00b1 348 mL vs. 820 \u00b1 141 mL;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.026). The time to diuresis was shorter in the PPV group (median 1 min [IQR 1\u20132] vs. 2 min [IQR 1\u20133];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0008). Incidence of hypotension and lactate levels post clamp release did not differ between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PPV-guided therapy reduced fluid requirements and accelerated diuresis without increasing hypotension or lactate levels, supporting dynamic over static preload indices for optimizing graft perfusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sja.sja_915_25","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T07:00:33Z","timestamp":1775199633000},"page":"369-374","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pulse pressure variation versus central venous pressure guided fluid management therapy in kidney transplant recipients: A single-blinded prospective randomized control study"],"prefix":"10.4103","volume":"20","author":[{"given":"Saurabh","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Asian Institute of Medical Sciences, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divesh","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Asian Institute of Medical Sciences, Faridabad, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"R1-20260421","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.atc.2004.05.007","article-title":"Kidney transplantation: Recent developments and recommendations for anesthetic management","volume":"22","author":"Lemmens","year":"2004","journal-title":"Anesthesiol Clin North Am"},{"key":"R2-20260421","doi-asserted-by":"crossref","first-page":"2829","DOI":"10.2337\/diacare.27.12.2829","article-title":"End-stage renal disease-associated managed care costs among patients with and without diabetes","volume":"27","author":"Joyce","year":"2004","journal-title":"Diabetes Care"},{"key":"R3-20260421","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1111\/j.1600-6143.2011.03754.x","article-title":"Delayed graft function in the kidney transplant","volume":"11","author":"Siedlecki","year":"2011","journal-title":"Am J Transplant"},{"key":"R4-20260421","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s13054-017-1928-2","article-title":"Perioperative fluid management in kidney transplantation: A black box","volume":"22","author":"Calixto Fernandes","year":"2018","journal-title":"Crit Care"},{"key":"R5-20260421","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1213\/ANE.0b013e3181d82ca8","article-title":"The impact of timing of maximal crystalloid hydration on early graft function during kidney transplantation","volume":"110","author":"Othman","year":"2010","journal-title":"Anesth Analg"},{"key":"R6-20260421","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1378\/chest.07-2331","article-title":"Does central venous pressure predict fluid responsiveness?: A systematic review of the literature and the tale of seven mares","volume":"134","author":"Marik","year":"2008","journal-title":"Chest"},{"key":"R7-20260421","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1097\/CCM.0b013e31828a25fd","article-title":"Does the central venous pressure predict fluid responsiveness? An updated meta-analysis and a plea for some common sense","volume":"41","author":"Marik","year":"2013","journal-title":"Crit Care Med"},{"key":"R8-20260421","doi-asserted-by":"crossref","first-page":"2642","DOI":"10.1097\/CCM.0b013e3181a590da","article-title":"Dynamic changes in arterial waveform derived variables and fluid responsiveness in mechanically ventilated patients: A systematic review of the literature","volume":"37","author":"Marik","year":"2009","journal-title":"Crit Care Med"},{"key":"R9-20260421","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1186\/s13054-014-0650-6","article-title":"Does pulse pressure variation predict fluid responsiveness in critically ill patients? A systematic review and meta-analysis","volume":"18","author":"Yang","year":"2014","journal-title":"Crit Care"},{"key":"R10-20260421","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1186\/s13054-024-05078-9","article-title":"Assessment of fluid responsiveness using pulse pressure variation, stroke volume variation, plethysmographic variability index, central venous pressure, and inferior vena cava variation in patients undergoing mechanical ventilation: A systematic review and meta-analysis","volume":"28","author":"Chaves","year":"2024","journal-title":"Crit Care"},{"key":"R11-20260421","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.bjan.2020.02.008","article-title":"Pulse pressure variation guided fluid therapy during kidney transplantation: A randomized controlled trial","volume":"70","author":"De Cassai","year":"2020","journal-title":"Braz J Anesthesiol"},{"key":"R12-20260421","doi-asserted-by":"crossref","first-page":"628","DOI":"10.4103\/joacp.JOACP_23_20","article-title":"A randomized comparison between pulse pressure variation and central venous pressure in patients undergoing renal transplantation","volume":"37","author":"Goyal","year":"2021","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R13-20260421","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1007\/s00540-015-2046-4","article-title":"Effect of intraoperative transoesophageal Doppler-guided fluid therapy versus central venous pressure-guided fluid therapy on renal allograft outcome in patients undergoing living donor renal transplant surgery: A comparative study","volume":"29","author":"Srivastava","year":"2015","journal-title":"J Anesth"},{"key":"R14-20260421","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1007\/s12630-021-02130-y","article-title":"The effect of pulse pressure variation compared with central venous pressure on intraoperative fluid management during kidney transplant surgery: A randomized controlled trial","volume":"69","author":"Kannan","year":"2022","journal-title":"Can J Anaesth"},{"issue":"Suppl 1","key":"R15-20260421","doi-asserted-by":"crossref","first-page":"S288","DOI":"10.4285\/ATW2022.F-4275","article-title":"Pulse pressure variation-guided intraoperative fluid management in kidney transplant recipients","volume":"36","author":"Myei","year":"2022","journal-title":"Korean J Transplantat"},{"key":"R16-20260421","first-page":"7848","article-title":"Effectiveness of central venous pressure versus stroke volume variation in guiding fluid management in renal transplantation","volume":"13","author":"Zhang","year":"2021","journal-title":"Am J Transl Res"},{"key":"R17-20260421","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1111\/tri.13926","article-title":"Early perioperative fluid overload is associated with adverse outcomes in deceased donor kidney transplantation","volume":"34","author":"Jia","year":"2021","journal-title":"Transpl Int"},{"key":"R18-20260421","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.3390\/jpm12071168","article-title":"Closed-loop controlled fluid administration systems: A comprehensive scoping review","volume":"12","author":"Avital","year":"2022","journal-title":"J Pers Med"},{"key":"R19-20260421","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1097\/ALN.0000000000002300","article-title":"Machine-learning algorithm to predict hypotension based on high-fidelity arterial pressure waveform analysis","volume":"129","author":"Hatib","year":"2018","journal-title":"Anesthesiology"}],"container-title":["Saudi Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_915_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:43:19Z","timestamp":1787067799000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sja.sja_915_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/sja.sja_915_25","relation":{},"ISSN":["1658-354X","0975-3125"],"issn-type":[{"value":"1658-354X","type":"print"},{"value":"0975-3125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-11-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}