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肾移植受者供肾术前体积与肾功能之间存在相关性吗?:一项容积计算机断层扫描研究。

Is There a Correlation with Pre-donation Kidney Volume and Renal Function in the Renal Transplant Recipient?: A Volumetric Computed Tomography Study.

作者信息

Coruh Aysegul Gursoy, Uzun Caglar, Akkaya Zehra, Gulpinar Basak, Elhan Atilla, Tuzuner Acar

机构信息

Department of Radiology, Ankara University Medical School, Ankara, Turkey.

Department of Radiology, Ankara University Medical School, Ankara, Turkey.

出版信息

Transplant Proc. 2019 Sep;51(7):2312-2317. doi: 10.1016/j.transproceed.2019.02.039. Epub 2019 Aug 7.

Abstract

PURPOSE

The aim of this study is to determine the correlation between the predonation computed tomography (CT)-based calculated kidney volume and post-transplant renal function in recipients of renal transplants and to compare two different CT techniques.

MATERIAL AND METHODS

The study group is comprised of 55 paired living kidney donor-recipients transplants. The total parenchymal renal volumes were calculated by using two CT-based techniques (3-dimensional renal volume [3DRV] and voxel-based volume calculation). Post-transplant creatinine and estimated glomerular filtration rate (eGFR) levels for the recipients at hospital discharge and sixth month were obtained. We tested the association with eGFR and creatinine by adjusting the renal volume to body weight and body mass index. For the creatinine levels above 1.5 mg/dL at discharge, a threshold value for renal volume-to-weight ratio on receiver operating characteristic curve (ROC) analysis and odds ratio (OR) were calculated.

RESULTS

The renal volumes adjusted to weight were found to be moderately correlated with eGFR and creatinine levels at discharge (r = 0.51 and r = -0.54 for voxel-based calculation; r = 0.52 and r = -0.52 for 3DRV calculation, P < .001, respectively) and at sixth month (r = 0.55 and r = -0.58 for voxel-based calculation; r = 0.51 and r = -0.54 for 3DRV calculation, P < .001 respectively). A threshold value of 1.84 mL/kg was calculated for parenchymal volume-to-recipient weight ratio on ROC analysis (AUC±SE, 0.760 ± 0.078, P = .008). The likelihood of creatinine elevation above 1.5 mg/dL was found to be nine times greater for smaller renal volume-to-recipient weight ratios (OR = 9.6; 95% CI, 1.8-50.6) CONCLUSIONS: Predonation renal volume adjusted to recipient weight may estimate the renal function at discharge and 6 months after transplantation.

摘要

目的

本研究旨在确定肾移植受者术前基于计算机断层扫描(CT)计算的肾脏体积与移植后肾功能之间的相关性,并比较两种不同的CT技术。

材料与方法

研究组由55对活体肾供受者移植组成。采用两种基于CT的技术(三维肾脏体积[3DRV]和基于体素的体积计算)计算肾脏实质总体积。获取受者出院时及术后第六个月的肌酐和估计肾小球滤过率(eGFR)水平。我们通过将肾脏体积调整为体重和体重指数来测试其与eGFR和肌酐的关联。对于出院时肌酐水平高于1.5mg/dL的情况,计算了受试者工作特征曲线(ROC)分析中肾脏体积与体重比的阈值以及比值比(OR)。

结果

调整体重后的肾脏体积与出院时的eGFR和肌酐水平呈中度相关(基于体素计算,r = 0.51和r = -0.54;3DRV计算,r = 0.52和r = -0.52,P均<0.001),与术后第六个月的情况也呈中度相关(基于体素计算,r = 0.55和r = -0.58;3DRV计算,r = 0.51和r = -0.54,P均<0.001)。ROC分析得出实质体积与受者体重比的阈值为1.84mL/kg(AUC±SE,0.760±0.078,P = 0.008)。发现肾脏体积与受者体重比越小,肌酐升高至高于1.5mg/dL的可能性大九倍(OR = 9.6;95%CI,1.8 - 50.6)。结论:调整为受者体重的术前肾脏体积可估计移植后出院时及6个月的肾功能。

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