Remnant renal volume can predict prognosis of remnant renal function in kidney transplantation donors: a prospective observational study

Shunta Hori,Mitsuru Tomizawa,Tatsuo Yoneda,Kiyohide Fujimoto,Kazumasa Torimoto,Yasushi Nakai,Makito Miyake,Nobumichi Tanaka,Tomonori Nakahama,Nobutaka Nishimura,Kiyoyuki Minamiguchi

doi:10.1186/s12882-021-02568-8

Shunta Hori, Mitsuru Tomizawa + Show 9 more

Open Access

https://doi.org/10.1186/s12882-021-02568-8

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Journal: BMC Nephrology	Publication Date: Nov 6, 2021
Citations: 5	License type: open-access

Affiliation: Nara Medical University

Abstract

BackgroundSafety and survival during and after donor nephrectomy (DN) are one of the main concerns in living kidney donors (LKDs). Therefore, kidney (left/right) to be procured should be determined after considering the difficulty of DN, as well as the preservation of remnant renal function (RRF). In this prospective study, we investigated the roles of computed tomography volumetry (CTV) in split renal function (SRF) and established a predictive model for RRF in LKDs.MethodsWe assessed 103 LKDs who underwent DN at our institute. The Volume Analyzer SYNAPSE VINCENT image analysis system were used as CTV. RRF was defined as the estimated glomerular filtration rate (eGFR) 12 months after DN. The association between various factors measured by CTV and RRF were investigated, and a role of CTV on prediction for RRF was assessed.ResultsThe median age and the preoperative eGFR were 58 years and 80.7 mL/min/1.73m2, respectively. Each factor measured by CTV showed an association with RRF. The ratio of remnant renal volume to body surface area (RRV/BSA) could predict RRF. In addition, RRV/BSA could predict RRF more accurately when used together with age and 24-h creatinine clearance (CrCl).ConclusionsOur findings suggest that RRV/BSA measured by CTV can play an important role in predicting RRF, and a comprehensive assessment including age and CrCl is important to determine the kidney to be procured.

Highlights

Safety and survival during and after donor nephrectomy (DN) are one of the main concerns in living kidney donors (LKDs)
The present study shows that volume parameters calculated by computed tomography volumetry (CTV) and Measured GFR (mGFR) measured by 99 m-Tc diethylenetriamine penta-acetic acid (DTPA) scintigraphy had strong correlations with remnant renal function (RRF)
We demonstrated that CTV could measure split renal function (SRF) and predicted RRF accurately in LKDs compared to measurement by 99 m-Tc DTPA scintigraphy

Summary

Introduction

Safety and survival during and after donor nephrectomy (DN) are one of the main concerns in living kidney donors (LKDs). Kidney (left/right) to be procured should be determined after considering the difficulty of DN, as well as the preservation of remnant renal function (RRF). In this prospective study, we investigated the roles of computed tomography volumetry (CTV) in split renal function (SRF) and established a predictive model for RRF in LKDs. Living donor kidney transplantation (LDKT) provides a better graft and patient outcome compared to deceased donor kidney transplantation (KT) [1]. The careful consideration should be given to the decision to donate, i.e. the procured kidney side Remnant renal function (RRF) is closely correlated with the risk of end-stage renal disease (ESRD), cardiovascular disease, and cerebrovascular disease after DN, which affect the prognosis of LKDs [2,3,4,5]

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