Use of Preoperative Renal Volumetry to Predict Postdonation Renal Function With Inulin Clearance as Indicator in Japan

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.05.017

Asuka Sano , Takayuki Sugiyama , Shinsuke Isobe , Yoshihiro Tsuchiya , Gaku Ishikawa , Ayana Takemura , Syunsuke Watanabe , Kyohei Watanabe , Yuto Matsushita , Hiromitsu Watanabe , Keita Tamura , Daisuke Motoyama , Atsushi Otsuka , Teruo Inamoto

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引用次数: 0

Abstract

Purpose

The aim of this study was to investigate the utility of preoperative CT-based renal volume assessment to predict postoperative renal function in living kidney donors. Specifically, favorable renal function was defined as chronic kidney disease (CKD) stage 1 or 2 at 1 year after donation, determined by the glomerular filtration rate (GFR) measured based on inulin clearance (Cin).

Methods

This study included 40 donors who underwent kidney donation at our institution between June 2012 and May 2021. GFR was measured using Cin, and CKD stages were assigned accordingly. Predictive factors for favorable renal function (CKD stage 1 or 2) at 1 year postdonation were analyzed using logistic regression.

Results

The median donor age was 63 years (range: 37-75), and 35.0% were male. Median pre- and postoperative Cin values were 84.9 (range: 59.0-133.4) and 56.7 (range: 34.7-95.0) mL/min, respectively. Multivariate logistic regression revealed age ≤ 55 and residual kidney volume-to-weight ratio (RKV/W) ≥ 2.78 as independent factors predicting favorable renal function. A scoring system based on these factors (0 points for none, 1 point for 1 factor, 2 points for both) demonstrated significantly better postoperative renal function in donors with 1 or more points compared with those with 0 points (median Cin: 63.3 vs 53.7 mL/min, respectively, P = .00074).

Conclusions

Age and RKV/W are factors predicting favorable renal function after kidney donation. A predictive scoring system based on these factors could assist in assessing donor eligibility and guiding clinical decision-making.

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在日本，以菊粉清除率为指标，术前肾容量测定预测捐献后肾功能。

目的：本研究的目的是探讨术前基于ct的肾容量评估在预测活体肾供者术后肾功能方面的应用。具体来说，良好的肾功能被定义为捐献后1年的慢性肾脏疾病（CKD） 1期或2期，由基于菊粉清除率（Cin）测量的肾小球滤过率（GFR）确定。方法：本研究纳入了2012年6月至2021年5月期间在我院接受肾脏捐赠的40名献血者。用Cin测定GFR，并据此确定CKD分期。使用logistic回归分析捐献后1年肾功能良好（CKD 1期或2期）的预测因素。结果：供体年龄中位数为63岁（37 ~ 75岁），男性占35.0%。术前和术后中位Cin值分别为84.9（范围59.0-133.4）和56.7（范围34.7-95.0）mL/min。多因素logistic回归分析显示，年龄≤55岁、残肾体积重量比(RKV/W)≥2.78是预测肾功能良好的独立因素。基于这些因素的评分系统（无因素为0分，1因素为1分，两个因素均为2分）显示，与0分的供者相比，1分或更多分的供者术后肾功能明显更好（中位Cin分别为63.3 vs 53.7 mL/min, P = 0.00074）。结论：年龄和RKV/W是预测肾脏捐献后肾功能良好的因素。基于这些因素的预测评分系统可以帮助评估供体资格并指导临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.