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

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

doi:10.1186/s12882-021-02568-8

Cited by 6 publications

(7 citation statements)

References 36 publications

(29 reference statements)

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“…The influence of cortex volume on postdonation renal function has been addressed previously, demonstrating correlations between volume and GFR after 1 y. 30,[34][35][36] Our data further reveal that cortex volume is independently associated with renal outcome even after adjustment of multiple factors including GFR of the nondonated kidney. Recent reports suggest that contrast-enhanced CT scans with determination of cortex volume could substitute measurement of skGFR.…”

Section: Renal Outcome In Lkdssupporting

confidence: 72%

Prediction of Renal Function in Living Kidney Donors and Recipients of Living Donor Kidneys Using Quantitative Histology

et al. 2022

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Background. Living kidney donors (LKDs) are at increased risk of chronic kidney disease, whereas transplant recipients experience progressive reduction of graft function. We examined the predictive value of quantitative stereology on renal function in LKDs and recipients of living donor kidneys, based on perioperative biopsies from the donated kidney. Methods. Cortex volume of both donor kidneys was determined by contrast-enhanced computed tomography and single-kidney glomerular filtration rate (GFR) by 51chrome-EDTA clearance together with renography. Glomerular density was used to estimate total glomeruli number in addition to glomerular volume, glomerular sclerosis, kidney fibrosis, and arteriole dimensions. GFR measurements were repeated 1 y after transplantation in both LKDs and recipients. Associations between GFR at follow-up and cortex volume and histomorphometric parameters after adjustment of age, gender, body mass index, smoking status, 24-h blood pressure, and single-kidney GFR were examined. Results. We included 49 LKDs (age, 51 ± 12 y) and 51 recipients (age, 44 ± 13 y). At follow-up, GFR was 71 ± 16 mL/min in LKDs and 61 ± 18 mL/min in recipients with hyperfiltration being more prominent in LKDs (30.4%) as compared to recipients (16.4%; P < 0.05). One-year GFR in donors correlated to cortex volume (P < 0.001) but not to any histological parameters, whereas GFR in recipients correlated to the amount of interstitial fibrosis (P < 0.01) but not to other histological parameters or cortex volume. Conclusions. Kidney cortex volume, but not renal histology parameters, predicts 1-y renal outcome in LKDs. In contrast, the amount of interstitial fibrosis, but not cortex volume, predicts 1-y graft function in recipients.

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Section: Renal Outcome In Lkdssupporting

confidence: 72%

Prediction of Renal Function in Living Kidney Donors and Recipients of Living Donor Kidneys Using Quantitative Histology

et al. 2022

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“…The association with (cortical) kidney volume is in line with previous studies connecting kidney volume with (post-donation) GFR. 8,32 Our findings pave the way for future studies that identify underlying molecular mechanisms, define biomarkers and reveal the clinical potential of the post-donation increase in single-kidney GFR, both in and beyond kidney donation.…”

Section: Discussionmentioning

confidence: 82%

“…Mean eGFR was 91±15 mL/min/1.73m 2 before donation, 59±13 mL/min/1.73m 2 at three months post-donation (P<0.001 vs. pre-donation), and 62±13 and 63±13 mL/min/1.73m 2 at five and ten years after donation (both P<0.001 vs. three months post-donation). Median [25 th -75 th percentile] increase in eGFR beyond 50% of the pre-donation eGFR at three months post-donation was 12 [8][9][10][11][12][13][14][15][16][17][18] mL/min/1.73m 2 .…”

Section: Characteristics Of the Donor Cohortmentioning

confidence: 99%

“…5 A recent study identified a low nephron number for age as predictor for long-term risk of chronic kidney disease after living kidney donation. 6 Whether reduced nephron number or cortical kidney volume, which has also been linked with post-donation kidney function 7,8 , are associated with a less pronounced post-donation increase in single-kidney GFR is unknown.…”

Section: Introductionmentioning

confidence: 99%

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Early increase in single-kidney glomerular filtration rate after living kidney donation predicts long-term kidney function

Weijden

Mahesh

Londen

et al. 2022

Kidney International

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“…Nevertheless, significant advances have been made in the application of deep learning-based computer vision in urology. The medical imaging software used in the present study has previously shown success in reconstructing 3D simulations of kidney-specific anatomy from CT/MRI, which has since helped facilitate clampless PN and predict residual renal function in kidney transplant settings 14 , 27 . The same software also led to more accurate estimations of NBGFR after RN in RCC patients when compared to subjective estimations of NBGFR made by expert urologic oncologists 6 .…”

Section: Discussionmentioning

confidence: 99%

Point of care parenchymal volume analyses to estimate split renal function and predict functional outcomes after radical nephrectomy

Rathi

Attawettayanon

Yasuda

et al. 2023

Sci Rep

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Accurate prediction of new baseline GFR (NBGFR) after radical nephrectomy (RN) can inform clinical management and patient counseling whenever RN is a strong consideration. Preoperative global GFR, split renal function (SRF), and renal functional compensation (RFC) are fundamentally important for the accurate prediction of NBGFR post-RN. While SRF has traditionally been obtained from nuclear renal scans (NRS), differential parenchymal volume analysis (PVA) via software analysis may be more accurate. A simplified approach to estimate parenchymal volumes and SRF based on length/width/height measurements (LWH) has also been proposed. We compare the accuracies of these three methods for determining SRF, and, by extension, predicting NBGFR after RN. All 235 renal cancer patients managed with RN (2006–2021) with available preoperative CT/MRI and NRS, and relevant functional data were analyzed. PVA was performed on CT/MRI using semi-automated software, and LWH measurements were obtained from CT/MRI images. RFC was presumed to be 25%, and thus: Predicted NBGFR = 1.25 × Global GFRPre-RN × SRFContralateral. Predictive accuracies were assessed by mean squared error (MSE) and correlation coefficients (r). The r values for the LWH/NRS/software-derived PVA approaches were 0.72/0.71/0.86, respectively (p < 0.05). The PVA-based approach also had the most favorable MSE, which were 120/126/65, respectively (p < 0.05). Our data show that software-derived PVA provides more accurate and precise SRF estimations and predictions of NBGFR post-RN than NRS/LWH methods. Furthermore, the LWH approach is equivalent to NRS, precluding the need for NRS in most patients.

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

Cited by 6 publications

References 36 publications

Prediction of Renal Function in Living Kidney Donors and Recipients of Living Donor Kidneys Using Quantitative Histology

Prediction of Renal Function in Living Kidney Donors and Recipients of Living Donor Kidneys Using Quantitative Histology

Early increase in single-kidney glomerular filtration rate after living kidney donation predicts long-term kidney function

Point of care parenchymal volume analyses to estimate split renal function and predict functional outcomes after radical nephrectomy

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