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

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

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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Abbreviations

AUC:

area under the curve

CT:

computed tomography

Cr-EDTA:

51Cr-ethylene-diamine tetra acetic acid

Tc-DTPA:

99mTc-diethylene-triamine penta acetic acid

GFR:

glomerular filtration rate

MDRD:

modification of diet in renal disease

ROC:

receiver operating characteristics

ROI:

region of interest

SRF:

split renal function

SRV:

split renal volume

OLS:

ordinary least squares

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Acknowledgments

The scientific guarantor of this publication is Marie Courbebaisse. François Gaillard thanks Ecole de l'INSERM-Liliane Bettencourt. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding.

No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained, REF2013-11-10. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Author notes

    Authors and Affiliations

    1. AP-HP, Hôpital Necker-Enfants Malades, Renal Transplantation Department, Paris Descartes University, Paris, France

      François Gaillard, Catherine Fournier, Carine Léon & Christophe Legendre

    2. Linköping University, Linköping, Sweden

      Patrik Pavlov

    3. AP-HP, Hôpital Necker-Enfants Malades, Radiology Department, Paris Descartes University, Paris, France

      Anne-Marie Tissier & Jean-Michel Correas

    4. AP-HP, Hôpital Européen Georges Pompidou, Nuclear Medicine Department, Paris Descartes University, Paris, France

      Benoit Harache, Chantal Hignette & Pierre Weinmann

    5. AP-HP, Hôpital Européen Georges Pompidou, Physiology Department, Paris Descartes University, and INSERM, Unit 970, Paris, France

      Dominique Eladari

    6. AP-HP, Hôpital Européen Georges Pompidou, Urology Department, Paris Descartes University, Paris, France

      Marc-Olivier Timsit & Arnaud Méjean

    7. AP-HP, Hôpital Européen Georges Pompidou, Physiology Department, Paris Descartes University, and INSERM, Unit 1151, Paris, France

      Gérard Friedlander & Marie Courbebaisse

    8. AP-HP, Hôpital Européen Georges Pompidou, Physiology Department, Paris Descartes University, INSERM, Unit umrs1138, and CNRS Unit erl8228, Paris, France

      Pascal Houillier

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    1. François Gaillard
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    Correspondence to François Gaillard.

    Additional information

    Christophe Legendre and Marie Courbebaisse contributed equally to this work.

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    Gaillard, F., Pavlov, P., Tissier, AM. et al. Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors. Eur Radiol 27, 651–659 (2017). https://doi.org/10.1007/s00330-016-4410-7

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