Renal cortical volume: High correlation with pre- and post-operative renal function in living kidney donors

Gardan, Edouard; Jacquemont, Lola; Perret, Christophe; Heudes, Pierre-Marie; Gourraud, Pierre-Antoine; Hourmant, Maryvonne; Frampas, É.; Limou, Sophie

doi:10.1016/j.ejrad.2017.12.013

Cited by 28 publications

(23 citation statements)

References 24 publications

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“…This is based on the observation that the average total volume used for analysis was 296 ± 30 ml, corresponding reasonably to the total anatomical VOI for both kidneys being 300 ml. This corresponds to the reported value for “total parenchymal three-dimensional volume” of 302 ml (range 215–499 ml) as determined by CT-volumetry in a recent study by Gardan et al [ 34 ]. As this volume corresponds to the entire kidney volume, including low flow regions contributing little to the total clearance, then the actual “renal volume” responsible for high flow rates must be smaller.…”

Section: Discussionsupporting

confidence: 83%

Estimation of renal perfusion based on measurement of rubidium-82 clearance by PET/CT scanning in healthy subjects

et al. 2021

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Background Changes in renal blood flow (RBF) may play a pathophysiological role in hypertension and kidney disease. However, RBF determination in humans has proven difficult. We aimed to confirm the feasibility of RBF estimation based on positron emission tomography/computed tomography (PET/CT) and rubidium-82 (82Rb) using the abdominal aorta as input function in a 1-tissue compartment model. Methods Eighteen healthy subjects underwent two dynamic 82Rb PET/CT scans in two different fields of view (FOV). FOV-A included the left ventricular blood pool (LVBP), the abdominal aorta (AA) and the majority of the kidneys. FOV-B included AA and the kidneys in their entirety. In FOV-A, an input function was derived from LVBP and from AA, in FOV-B from AA. One-tissue compartmental modelling was performed using tissue time activity curves generated from volumes of interest (VOI) contouring the kidneys, where the renal clearance of 82Rb is represented by the K1 kinetic parameter. Total clearance for both kidneys was calculated by multiplying the K1 values with the volume of VOIs used for analysis. Intra-assay coefficients of variation and inter-observer variation were calculated. Results For both kidneys, K1 values derived from AA did not differ significantly from values obtained from LVBP, neither were significant differences seen between AA in FOV-A and AA in FOV-B, nor between the right and left kidneys. For both kidneys, the intra-assay coefficients of variation were low (~ 5%) for both input functions. The measured K1 of 2.80 ml/min/cm3 translates to a total clearance for both kidneys of 766 ml/min/1.73 m2. Conclusion Measurement of renal perfusion based on PET/CT and 82Rb using AA as input function in a 1-tissue compartment model is feasible in a single FOV. Based on previous studies showing 82Rb to be primarily present in plasma, the measured K1 clearance values are most likely representative of effective renal plasma flow (ERPF) rather than estimated RBF values, but as the accurate calculation of total clearance/flow is very much dependent on the analysed volume, a standardised definition for the employed renal volumes is needed to allow for proper comparison with standard ERPF and RBF reference methods.

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Section: Discussionsupporting

confidence: 83%

Estimation of renal perfusion based on measurement of rubidium-82 clearance by PET/CT scanning in healthy subjects

et al. 2021

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“…Narasimhamurthy et al evaluated 85 donors and found those with larger combined kidney volumes adjusted for BSA were more likely and more quickly to achieve eGFR values of 60 mL/min/1.73 m 2 or more, but the researchers did not report associations for remaining kidney volume nor did they adjust for baseline eGFR or other donor factors. In a French cohort of 105 donors, Gardan et al found that the unadjusted cortical volume of the remaining kidney predicted measured GFR <60 mL/min/1.73 m 2 at 1 year with an area under the receiver‐operating characteristic curve of 0.80 . Most recently, Lange et al used contrast‐enhanced magnetic resonance imaging (MRI) to measure pre‐donation kidney volumes compared with split renal function as assessed by 99m Tc‐labelled mercapto‐acetyltriglycin (MAG3) scintigraphy in a German cohort of 100 living kidney donors.…”

Section: Discussionmentioning

confidence: 99%

Baseline living‐donor kidney volume and function associate with 1‐year post‐nephrectomy kidney function

Hall

Shaaban

Wei

et al. 2019

Clinical Transplantation

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Living donors may develop kidney dysfunction more often than equally healthy populations. The purpose of this study was to determine whether computed tomography‐assessed remaining kidney volume indexed to body surface area (RKV/BSA) was associated with 1‐year post‐nephrectomy renal function independent of baseline renal function. Using multivariable regression, we modeled 1‐year estimated glomerular filtration rate (eGFR) and eGFR <60 mL /min/1.73 m2 and considered pre‐determined baseline eGFR subgroups in 151 consecutive donors. Mean ± SD baseline age, eGFR, RKV, BSA, and RKV/BSA were 38 ± 11 years, 97 ± 16 mL/min/1.73 m2, 153 ± 29 mL, 1.9 ± 0.2 m2, and 80.0 ± 12.8 ml/m2, respectively; 50% were female and 94% were white. Mean baseline eGFR was greater with increasing RKV/BSA tertiles (92 ± 14, 97 ± 16, 107 ± 16 mL/min/1.73 m2; P < 0.001). Post‐nephrectomy eGFR remained separated by RKV/BSA tertiles. At baseline, each SD greater RKV/BSA and eGFR was independently associated with higher adjusted 1‐year eGFR by 2.4 and 9.2 mL/min/1.73 m2. Each SD greater age associated with 2.2 mL/min/1.73 m2 lower adjusted 1‐year eGFR. Adjusted odds of 1‐year eGFR <60 increased significantly for donors with RKV/BSA <80 mL/m2. With baseline eGFR <90, probability of 1‐year eGFR <60 increased to >80% with decreasing RKV/BSA values below 80 mL/m2. Those with baseline eGFR >100 rarely developed 1‐year eGFR <60 if RKV/BSA remained >60 mL/m2. RKV/BSA independently associated with 1‐year eGFR <60, especially with lower baseline eGFRs. Additional studies should evaluate the predictive utility of this measure and its potential role in donor evaluations and informed consent.

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“…Our present estimation of parenchymal volumes, whether by software analysis or free‐hand scripting, included all enhancing renal parenchyma, similar to most previous studies in the literature. However, some studies have focussed only on cortical volume, where most of the glomeruli reside, but this requires free‐hand scripting and is more difficult because the boundaries between the cortex and medulla are not always well‐defined, particularly in older patients or those with a history of renal intervention or inflammatory processes . Other studies in this literature have used the simple elliptical formula (height × width × length × 0.52) to estimate parenchymal volumes , but this approach is less accurate and it does not exclude the collecting system, hilar vessels, cysts, sinus fat, and tumour, which are routinely excluded with our methodology .…”

Section: Discussionmentioning

confidence: 99%

Split renal function in patients with renal masses: utility of parenchymal volume analysis vs nuclear renal scans

Tanaka

Wang

et al. 2020

BJU International

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Renal cortical volume: High correlation with pre- and post-operative renal function in living kidney donors

Cited by 28 publications

References 24 publications

Estimation of renal perfusion based on measurement of rubidium-82 clearance by PET/CT scanning in healthy subjects

Estimation of renal perfusion based on measurement of rubidium-82 clearance by PET/CT scanning in healthy subjects

Baseline living‐donor kidney volume and function associate with 1‐year post‐nephrectomy kidney function

Split renal function in patients with renal masses: utility of parenchymal volume analysis vs nuclear renal scans

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