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The assessment of renal cortex and parenchymal volume using automated CT volumetry for predicting renal function after donor nephrectomy

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Abstract

Background

Contrast-enhanced CT is necessary before donor nephrectomy and is usually combined with a Tc-99m-mercapto-acetyltriglycine (MAG3) scan to check split renal function (SRF). However, all transplant programs do not use MAG3 because of its high cost and exposure to radiation. We examined whether CT volumetry of the kidney can be a new tool for evaluating SRF.

Methods

Sixty-three patients underwent live donor nephrectomy. Patients without a 1.0 mm slice CT or follow-up for <12 months were excluded leaving 34 patients’ data being analyzed. SRF was measured by MAG3. Split renal volume (SRV) was calculated automatically using volume analyzer software. The correlation between SRF and SRV was examined. The association between the donor’s postoperative estimated glomerular filtration rate (eGFR) and predicted eGFR calculated by MAG3 or CT volumetry was analyzed at 1, 3, and 12 months post nephrectomy.

Results

Strong correlations were observed preoperatively in a Bland–Altman plot between SRF measured by MAG3 and either CT cortex or parenchymal volumetry. In addition, eGFR after donation correlated with SRF measured by MAG3 or CT volumetry. The correlation coefficients (R) for eGFR Mag3 split were 0.755, 0.615, and 0.763 at 1, 3 and 12 months, respectively. The corresponding R values for cortex volume split were 0.679, 0.638, and 0.747. Those for parenchymal volume split were 0.806, 0.592, and 0.764.

Conclusion

Measuring kidney by CT volumetry is a cost-effective alternative to MAG3 for evaluating SRF and predicting postoperative donor renal function. Both cortex and parenchymal volumetry were similarly effective.

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Authors and Affiliations

  1. Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Yosuke Mitsui, Takuya Sadahira, Motoo Araki, Koichiro Wada, Ryuta Tanimoto, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe & Yasutomo Nasu

  2. Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Yosuke Mitsui, Takuya Sadahira, Motoo Araki, Koichiro Wada, Ryuta Tanimoto, Yuichi Ariyoshi, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe & Yasutomo Nasu

Authors
  1. Yosuke Mitsui
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  2. Takuya Sadahira
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  3. Motoo Araki
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  4. Koichiro Wada
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  5. Ryuta Tanimoto
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  6. Yuichi Ariyoshi
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  7. Yasuyuki Kobayashi
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  8. Masami Watanabe
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  9. Toyohiko Watanabe
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  10. Yasutomo Nasu
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Corresponding author

Correspondence to Takuya Sadahira.

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The authors have declared that no conflict of interest exists.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

This clinical study was approved by the Okayama University Institutional Review Board prior to study initiation (Registration No. 951).

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Cite this article

Mitsui, Y., Sadahira, T., Araki, M. et al. The assessment of renal cortex and parenchymal volume using automated CT volumetry for predicting renal function after donor nephrectomy. Clin Exp Nephrol 22, 453–458 (2018). https://doi.org/10.1007/s10157-017-1454-1

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  • DOI: https://doi.org/10.1007/s10157-017-1454-1

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