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

Gaillard, François; Pavlov, Patrik; Tissier, Anne-Marie; Harache, Benoit; Eladari, Dominique; Timsit, Marc-Olivier; Fournier, Catherine; Léon, Carine; Hignette, Chantal; Friedlander, Gérard; Correas, Jean-Michel; Weinmann, Pierre; Méjean, Arnaud; Houillier, Pascal; Legendre, Christophe; Courbebaisse, Marie.
Eur Radiol; 27(2): 651-659, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27221559

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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