Department of General Surgery, Istanbul Okan University, Faculty of Medicine, Tuzla Istanbul 34759, Turkey.
Department of Radiodiagnostics, Istanbul Okan University, Faculty of Medicine, Tuzla Istanbul 34759, Turkey.
Urol J. 2020 Jun 23;17(4):379-385. doi: 10.22037/uj.v0i0.5558.
Recent studies reported that the presence of metabolic syndrome is closely correlated with impaired kidney function after living donor nephrectomy. Since the measurement of body mass index cannot differentiate the amount of body adipose tissue from total body weight, body mass index is not a reliable parameter for determining metabolic syndrome. In the present study, we investigated the correlation between body adipose tissue and kidney function recovery following living donor nephrectomy.
The patients who underwent living kidney donor nephrectomy consequently from July 2016 through December 2017 were enrolled in the study. We preoperatively measured the visceral (VAdT), retroperitoneal (RPAdT), and subcutaneous (SCAdT) adipose tissue volume by a computed tomography scan. Body mass index, adipose tissue measurements, and postoperative estimated glomerular filtration rate (eGFR) were evaluated.
The decrease between preoperative eGFR, and the first day, the first month and the sixth month eGFR after surgery were statistically significant (P = .001; P = .001; P = .001, respectively). The negative correlation between VAdT/SCAdT measurements and changes in eGFR at the first and the sixth postoperative month compared to preoperative eGFR were statistically significant (P = .049; P = .041, respectively). Additionally, RPAdT measurements and changes in eGFR at the first and the sixth postoperative month compared to preoperative eGFR (decreasing as RPAdT value increased) were statistically significant (P = .035; P = .026, respectively).
According to a preoperative computed tomography scan, VAdT, RPAdT, and VAdT-to-SAdT ratio can predict impaired kidney function recovery. Furthermore, RPAdT measurement is a new variable to predict the impaired kidney function after living donor nephrectomy.
最近的研究报告称，代谢综合征的存在与活体供肾切除术后肾功能受损密切相关。由于体重指数的测量不能将身体脂肪组织的量与体重总量区分开来，因此体重指数不是确定代谢综合征的可靠参数。在本研究中，我们研究了活体供肾切除术后身体脂肪组织与肾功能恢复之间的相关性。
本研究纳入了 2016 年 7 月至 2017 年 12 月期间接受活体肾脏供体肾切除术的患者。我们通过计算机断层扫描术前测量了内脏（VAdT）、腹膜后（RPAdT）和皮下（SCAdT）脂肪组织体积。评估了体重指数、脂肪组织测量值和术后估算肾小球滤过率（eGFR）。
术前 eGFR 与术后第 1 天、第 1 个月和第 6 个月 eGFR 之间的下降具有统计学意义（P=.001；P=.001；P=.001，分别）。VAdT/SCAdT 测量值与术后第 1 个月和第 6 个月 eGFR 与术前 eGFR 相比的变化之间呈负相关，具有统计学意义（P=.049；P=.041，分别）。此外，RPAdT 测量值与术后第 1 个月和第 6 个月 eGFR 与术前 eGFR 相比的变化（随着 RPAdT 值的增加而降低）具有统计学意义（P=.035；P=.026，分别）。
根据术前计算机断层扫描，VAdT、RPAdT 和 VAdT/SCAdT 比值可以预测肾功能恢复受损。此外，RPAdT 测量值是预测活体供肾切除术后肾功能受损的一个新变量。
