2194 RENAL PARENCHYMAL VOLUME INCREASES AFTER CONTRALATERAL NEPHRECTOMY: ASSESSMENT USING THREE-DIMENSIONAL ULTRASONOGRAPHY

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You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 20122194 RENAL PARENCHYMAL VOLUME INCREASES AFTER CONTRALATERAL NEPHRECTOMY: ASSESSMENT USING THREE-DIMENSIONAL ULTRASONOGRAPHY Majima Tsuyoshi, Hattori Ryohei, Funahashi Yasuhito, Yamamoto Tokunori, and Gotoh Momokazu Majima TsuyoshiMajima Tsuyoshi Nagoya, Japan More articles by this author , Hattori RyoheiHattori Ryohei Nagoya, Japan More articles by this author , Funahashi YasuhitoFunahashi Yasuhito Nagoya, Japan More articles by this author , Yamamoto TokunoriYamamoto Tokunori Nagoya, Japan More articles by this author , and Gotoh MomokazuGotoh Momokazu Nagoya, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2368AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Removal of 1 kidney induces immediate hemodynamic changes in rats, which results in the increase of the contralateral kidney volume; however, this has not been confirmed in humans. The purpose of this study is to measure renal parenchymal volume (RPV) before and after unilateral nephrectomy and to clarify the relationship between changes of RPV and renal function. METHODS Forty-six consecutive patients undergoing unilateral nephrectomy were included. Three-dimensional ultrasonography (3D-US) was performed using LOGIQ7 ultrasound unit with a 2.0−5.0 MHz volume convex probe and RPV was calculated. We performed 3D-US before surgery (n = 46) and at 4.3 ± 1.9 hours (n = 46), 2 days (n = 39), and 7 days (n = 43) after surgery. For five patients who received open surgery in the supine position, we also performed 3D-US every 30 min, starting just before the renal artery transection. RESULTS The mean RPV of the remaining kidney was 104.7 ml before surgery, 116.1 ml (+13.2%) at 4.3 hours, 122.7 ml (+18.2%) at 2 days, and 117.6 ml (+13.3%) at 7 days after surgery. Sequential volume measurements during surgery (n = 5) revealed that transection of the renal artery was followed by an increase in RPV on the contralateral side at 60−90 min (Fig. 1). Multivariate regression analysis revealed that RPV was positively associated with single kidney glomerular filtration rate (GFR) and body surface area (BSA) both in the preoperative and postoperative states (Table 1). An increase in the single-kidney GFR was not seen at 2 years in patients with an RPV increase of <5% at 1 week (102.9 ± 8.4%, P = 0.322), but was still significant in the other patients (115.5 ± 21.0%, P < 0.001). Table 1. Statistical significance of preoperative factors related to RPV increase at 1 week Univariate analysis Multivariate analysis<> β p-value β p-value Gender -0.080 0.610 -0.058 0.700 Age 0.011 0.945 -0.074 0.654 BSA -0.062 0.694 0.347 0.027 RPV in the remaining kidney -0.527 <0.001 -0.804 <0.001 RPV in the resected kidney -0.194 0.223 -0.184 0.340 Single-kidney GFR in the remaining kidney -0.295 0.058 0.148 0.385 Single-kidney GFR in the resected kidney 0.114 0.471 0.349 0.013 Hypertension -0.104 0.506 -0.176 0.197 Diabetes mellitus 0.115 0.462 0.010 0.940 RPV; renal parenchymal volume, BSA; body surface area, GFR; glomerular filtration rate. CONCLUSIONS RPV began to increase at 60-90 min after nephrectomy and remained stable for at least 1 week. The change in RPV increased when the remaining kidney was small, the removed kidney had greater function, and BSA was large. The extent of the increase in RPV 1 week after nephrectomy may predict future deterioration in renal function. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e884-e885 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Majima Tsuyoshi Nagoya, Japan More articles by this author Hattori Ryohei Nagoya, Japan More articles by this author Funahashi Yasuhito Nagoya, Japan More articles by this author Yamamoto Tokunori Nagoya, Japan More articles by this author Gotoh Momokazu Nagoya, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...