Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors
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Screening of living kidney donors may require scintigraphy to split glomerular filtration rate (GFR). To determine the usefulness of computed tomography (CT) to split GFR, we compared scintigraphy-split GFR to CT-split GFR. We evaluated CT-split GFR as a screening test to detect scintigraphy-split GFR lower than 40 mL/min/1.73 m2/kidney.
This was a monocentric retrospective study on 346 potential living donors who had GFR measurement, renal scintigraphy, and CT. We predicted GFR for each kidney by splitting GFR using the following formula: Volume-split GFR for a given kidney = measured GFR*[volume of this kidney/(volume of this kidney + volume of the opposite kidney)]. The same formula was used for length-split GFR. We compared length- and volume-split GFR to scintigraphy-split GFR at donation and with a 4-year follow-up.
A better correlation was observed between length-split GFR and scintigraphy-split GFR (r = 0.92) than between volume-split GFR and scintigraphy-split GFR (r = 0.89). A length-split GFR threshold of 45 mL/min/1.73 m2/kidney had a sensitivity of 100 % and a specificity of 75 % to detect scintigraphy-split GFR less than 40 mL/min/1.73 m2/kidney. Both techniques with their respective thresholds detected living donors with similar eGFR evolution during follow-up.
Length-split GFR can be used to detect patients requiring scintigraphy.
• Excellent correlation between kidney length and scintigraphy predicted GFR
• Kidney length screening detects all donors with GFR lower than 40 mL/min/1.73 m 2
• Kidney length screening can replace scintigraphy screening.
Keywordsliving donor kidney renal transplantation CT split renal function/split GFR
area under the curve
51Cr-ethylene-diamine tetra acetic acid
99mTc-diethylene-triamine penta acetic acid
glomerular filtration rate
modification of diet in renal disease
receiver operating characteristics
region of interest
split renal function
split renal volume
ordinary least squares
The scientific guarantor of this publication is Marie Courbebaisse. François Gaillard thanks Ecole de l'INSERM-Liliane Bettencourt. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding.
No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained, REF2013-11-10. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.
- 3.Garg AX, Muirhead N, Knoll G, Yang RC, Prasad GV, Thiessen-Philbrook H et al (2006) (Donor Nephrectomy Outcomes Research (DONOR) Network). Proteinuria and reduced kidney function in living kidney donors: A systematic review, meta-analysis, and meta-regression. Kidney Int 70(10):1801–1810CrossRefPubMedGoogle Scholar
- 8.Tanriover B, Fernandez S, Campenot ES, Newhouse JH, Oyfe I, Mohan P, Sandikci B, Radhakrishnan J, Wexler JJ, Carroll MA, Sharif S, Cohen DJ, Ratner LE, Hardy MA (2015) Live Donor Renal Anatomic Asymmetry and Posttransplant Renal Function. Transplantation 99(8):e66–e74CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Diez A, Powelson J, Sundaram CP, Taber TE, Mujtaba MA, Yaqub MS et al (2014) Correlation between CT-based measured renal volumes and nuclear-renography-based split renal function in living kidney donors. Clinical diagnostic utility and practice patterns. Clin Transplant 28(6):675–682CrossRefPubMedGoogle Scholar
- 17.Soga S, Britz-Cunningham S, Kumamaru KK, Malek SK, Tullius SG, Rybicki FJ (2012) Comprehensive comparative study of computed tomography-based estimates of split renal function for potential renal donors: modified ellipsoid method and other CT-based methods. J Comput Assist Tomogr 36:323–329CrossRefPubMedGoogle Scholar
- 19.Delmonico FL: A report of the Amsterdam forum on thecare of the live kidney donor: data and medical guidelines.Transplantation 79[Suppl]: S53–S66, 2005Google Scholar