Song Turun, Fu Lei, Huang Zixing, He Shaofeng, Zhao Ruining, Lin Tao, Wei Qiang
Department of Urology, West China Hospital, Sichuan University, Guoxue Xiang #37, Chengdu, 610041, Sichuan, People's Republic of China.
Int Urol Nephrol. 2014 Apr;46(4):743-7. doi: 10.1007/s11255-013-0592-y. Epub 2013 Nov 1.
Uninephrectomy would induce compensatory hypertrophy in the remaining kidney. We investigated the relationship between changes in renal parenchymal volume (RPV) and renal function after nephrectomy in living kidney donors.
From July 2011 and January 2012, 45 kidney donors were enrolled in this study. Magnetic resonance scanning was performed before surgery, 3 and 7 days postoperatively, and RPV was calculated through disc summarize methods. Participants were followed up for 1 year.
The RPV of the remaining kidney was 118.06 ± 23.51 cm(3) and then increased by 21.23 % to 143.13 ± 25.52 cm(3) at 3 days and by 24.17 % to 146.60 ± 25.86 cm(3) at 7 days. Multivariate regression analysis showed that preoperative RPV is positively related to its initial function (p = 0.037); the RPV at 7 days is directly related to its initial, preoperative size (p < 0.001). With respect to change in postoperative RPV, there is bigger gain in size in smaller kidneys (p = 0.005). The kidneys that has ≥20 % increase RPV after 7 days are more likely to show further increase in GFR at 1 year (p = 0.024).
Uninephrectomy induced immediately increment in RPV of the remaining kidney. Donors with RPV increase of ≥20 % at 1 week have a more favourable renal function adaptation at 1 year.
单侧肾切除会诱导剩余肾脏发生代偿性肥大。我们研究了活体肾供体肾切除术后肾实质体积（RPV）变化与肾功能之间的关系。
2011年7月至2012年1月，45名肾供体纳入本研究。术前、术后3天和7天进行磁共振扫描，通过椎间盘汇总方法计算RPV。对参与者进行1年的随访。
剩余肾脏的RPV为118.06±23.51 cm³，术后3天增加21.23%至143.13±25.52 cm³，术后7天增加24.17%至146.60±25.86 cm³。多因素回归分析显示，术前RPV与其初始功能呈正相关（p = 0.037）；术后7天的RPV与其术前初始大小直接相关（p < 0.001）。关于术后RPV的变化，较小的肾脏体积增加更大（p = 0.005）。术后7天RPV增加≥20%的肾脏在1年时更有可能出现肾小球滤过率（GFR）进一步增加（p = 0.024）。
单侧肾切除立即导致剩余肾脏的RPV增加。术后1周RPV增加≥20%的供体在1年时具有更良好的肾功能适应性。
