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01-02-2017 | Computed Tomography

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

Authors: 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

Published in: European Radiology | Issue 2/2017

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.

Available only for authorised users

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Title: Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors
Authors: 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
Publication date: 01-02-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4410-7

At a glance: The STEP trials

Springer Medicine

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

Abstract

Objectives

Methods

Results

Conclusion

Key points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key points

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