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European Radiology

, Volume 27, Issue 2, pp 651–659 | Cite as

Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors

  • François GaillardEmail author
  • Patrik Pavlov
  • Anne-Marie Tissier
  • Benoit Harache
  • Dominique Eladari
  • Marc-Olivier Timsit
  • Catherine Fournier
  • Carine Léon
  • Chantal Hignette
  • Gérard Friedlander
  • Jean-Michel Correas
  • Pierre Weinmann
  • Arnaud Méjean
  • Pascal Houillier
  • Christophe Legendre
  • Marie Courbebaisse
Computed Tomography

Abstract

Objectives

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.

Methods

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.

Results

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.

Conclusion

Length-split GFR can be used to detect patients requiring scintigraphy.

Key points

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.

Keywords

living donor kidney renal transplantation CT split renal function/split GFR 

Abbreviations

AUC

area under the curve

CT

computed tomography

Cr-EDTA

51Cr-ethylene-diamine tetra acetic acid

Tc-DTPA

99mTc-diethylene-triamine penta acetic acid

GFR

glomerular filtration rate

MDRD

modification of diet in renal disease

ROC

receiver operating characteristics

ROI

region of interest

SRF

split renal function

SRV

split renal volume

OLS

ordinary least squares

Notes

Acknowledgments

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.

Supplementary material

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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • François Gaillard
    • 1
    Email author
  • Patrik Pavlov
    • 2
  • Anne-Marie Tissier
    • 3
  • Benoit Harache
    • 4
  • Dominique Eladari
    • 5
  • Marc-Olivier Timsit
    • 6
  • Catherine Fournier
    • 1
  • Carine Léon
    • 1
  • Chantal Hignette
    • 4
  • Gérard Friedlander
    • 7
  • Jean-Michel Correas
    • 3
  • Pierre Weinmann
    • 4
  • Arnaud Méjean
    • 6
  • Pascal Houillier
    • 8
  • Christophe Legendre
    • 1
  • Marie Courbebaisse
    • 7
  1. 1.AP-HP, Hôpital Necker-Enfants Malades, Renal Transplantation DepartmentParis Descartes UniversityParisFrance
  2. 2.Linköping UniversityLinköpingSweden
  3. 3.AP-HP, Hôpital Necker-Enfants Malades, Radiology DepartmentParis Descartes UniversityParisFrance
  4. 4.AP-HP, Hôpital Européen Georges Pompidou, Nuclear Medicine DepartmentParis Descartes UniversityParisFrance
  5. 5.AP-HP, Hôpital Européen Georges Pompidou, Physiology DepartmentParis Descartes University, and INSERM, Unit 970ParisFrance
  6. 6.AP-HP, Hôpital Européen Georges Pompidou, Urology DepartmentParis Descartes UniversityParisFrance
  7. 7.AP-HP, Hôpital Européen Georges Pompidou, Physiology DepartmentParis Descartes University, and INSERM, Unit 1151ParisFrance
  8. 8.AP-HP, Hôpital Européen Georges Pompidou, Physiology DepartmentParis Descartes University, INSERM, Unit umrs1138, and CNRS Unit erl8228ParisFrance

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