Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Urology. 2011 Jun;77(6):1404-8. doi: 10.1016/j.urology.2010.03.063. Epub 2010 Jun 8.
To measure the renal parenchymal volume (RPV) before and after unilateral nephrectomy and investigate the relationship between the RPV and single kidney glomerular filtration rate (GFR).
From November 2003 to August 2009, 183 patients who had undergone unilateral nephrectomy were enrolled in the present study. All patients had undergone preoperative technetium-99m dimercaptosuccinic acid renal scintigraphy. Contrast-enhanced computed tomography was performed before and 6 months after surgery. RPV was calculated as the normally functioning tissue, excluding tumors or nonenhanced areas, using a 3-dimensional image reconstruction program.
The mean split GFR of the remaining kidney increased by 21.2%, from 41.6 to 49.5 mL/min/1.73 m(2) at 6 months after nephrectomy. The mean RPV of the remaining kidney increased by 9.3%, from 164.2 to 178.8 cm(3) after nephrectomy. The preoperative relative RPV of the remaining kidney was 58.8% (range 37.2%-97.9%) and the technetium-99m dimercaptosuccinic acid uptake was 62.2% (range 39.6%-100%), indicating a significant linear correlation (R = 0.865, P <.001). RPV correlated well with the single kidney GFR and patient age, both preoperatively and postoperatively. The postoperative GFR could be predicted by combining the preoperative factors. Multivariate regression analysis revealed that the RPV was positively associated with the single kidney GFR and negatively associated with patient age.
The differential renal function correlated well with the RPV and can be estimated by calculating the RPV. Even without using renal scintigraphy, the postoperative GFR can be predicted using our established formula.
测量单侧肾切除术前和术后的肾实质体积（RPV），并探讨 RPV 与单肾肾小球滤过率（GFR）之间的关系。
本研究纳入了 2003 年 11 月至 2009 年 8 月期间接受单侧肾切除术的 183 例患者。所有患者均接受了术前锝-99m 二巯丁二酸肾闪烁显像。手术前后进行了增强 CT 检查。使用三维图像重建程序，计算出正常功能组织（不包括肿瘤或无增强区域）的 RPV。
术后 6 个月，对侧残留肾 GFR 平均增加了 21.2%，从 41.6 升至 49.5 mL/min/1.73 m2。对侧残留肾的 RPV 平均增加了 9.3%，从术前的 164.2 升至 178.8 cm3。术前对侧残留肾的相对 RPV 为 58.8%（范围 37.2%-97.9%），锝-99m 二巯丁二酸摄取率为 62.2%（范围 39.6%-100%），呈显著线性相关（R = 0.865，P <.001）。术前和术后，RPV 与单肾 GFR 和患者年龄均有良好的相关性。术后 GFR 可通过结合术前因素进行预测。多元回归分析显示，RPV 与单肾 GFR 呈正相关，与患者年龄呈负相关。
残肾功能与 RPV 密切相关，可通过计算 RPV 进行评估。即使不使用肾闪烁显像，也可使用我们建立的公式预测术后 GFR。
