Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Transplantation. 2011 Dec 27;92(12):1335-41. doi: 10.1097/TP.0b013e31823705ef.
Transplanted nephron mass is an important determinant of long-term allograft survival, but accurate assessment before organ retrieval is challenging. Newer radiologic imaging techniques allow for better determination of total kidney and cortical volumes.
Using volume measurements reconstructed from magnetic resonance or computed tomography imaging from living donor candidates, we characterized total kidney (n=312) and cortical volumes (n=236) according to sex, age, weight, height, body mass index (BMI), and body surface area (BSA).
The mean cortical volume was 204 mL (range 105-355 mL) with no significant differences between left and right cortical volumes. The degree to which existing anthropomorphic surrogates predict nephron mass was quantified, and a diligent attempt was made to derive a better surrogate model for nephron mass. Cortical volumes were strongly associated with sex and BSA, but not with weight, height, or BMI. Four prediction models for cortical volume constructed using combinations of age, sex, race, weight, and height were compared with models including either BSA or BMI.
Among existing surrogate measures, BSA was superior to BMI in predicting renal cortical volume. We were able to construct a statistically superior proxy for cortical volume, but whether relevant improvements in predictive accuracy could be gained needs further evaluation in a larger population.
移植肾单位质量是长期移植物存活的重要决定因素，但在器官获取前进行准确评估具有挑战性。较新的影像学技术可以更好地确定肾脏总容量和皮质体积。
使用来自活体供者候选者的磁共振或计算机断层扫描成像的体积测量值，我们根据性别、年龄、体重、身高、体重指数（BMI）和体表面积（BSA）对肾脏总容量（n=312）和皮质容量（n=236）进行了特征描述。
皮质容量的平均值为 204 mL（范围 105-355 mL），左、右皮质容量之间无显著差异。量化了现有人体测量替代物预测肾单位质量的程度，并努力为肾单位质量开发更好的替代模型。皮质容量与性别和 BSA 密切相关，但与体重、身高或 BMI 无关。使用年龄、性别、种族、体重和身高组合构建的皮质体积的四个预测模型与包含 BSA 或 BMI 的模型进行了比较。
在现有的替代指标中，BSA 在预测肾皮质体积方面优于 BMI。我们能够构建出一种统计学上更优越的皮质体积代理指标，但在更大的人群中是否能获得相关的预测准确性改进仍需进一步评估。
