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24.05.2016 | Computed Tomography

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

verfasst von: François Gaillard, 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

Erschienen in: European Radiology | Ausgabe 2/2017

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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.

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Titel: Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors
verfasst von: François Gaillard
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
Publikationsdatum: 24.05.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 2/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4410-7

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