Relationship of Kidney Length, Volume and Renal Split Function in Living Kidney Donors

S. Fernandez, S. Mohan, Z. Zaky, J. Crew, J. Dube, M. Carrol, J. Wexler, L. Ratner, D. Cohen, B. Tanriover

Nephrology, Columbia University Medical Center, New York, NY
Surgery, Columbia University Medical Center, New York, NY

Meeting: 2013 American Transplant Congress

Abstract number: 342

Purpose: All potential living donors at Columbia University Medical Center (CUMC) undergo abdominal CT imaging including estimation of kidney volume and length. Subjects with > 10% variation in kidney length undergo split renal function (SRF) using 99mTc-DMSA renal uptake scan to help determine the laterality of the donor nephrectomy. The purpose of this study was to determine the correlation between the variation in CT kidney length/volume and difference in estimates of kidney function.

Methods: We included all potential donors at CUMC between 2011 and 2012 who underwent both abdominal CT imaging and split renal function estimation. Length (LP) and volume percentages (VP) were calculated as L/R*100.

Results: Among the 180 potential live kidney donors, 96 (53%) underwent SRF as a result of variations in length (57%), volume (55%), or both (19%). The correlation between the length and volume was poor (r=0.14). Among patients who had SRF, the mean kidney lengths and volumes between L and R were 10.5±1.13 cm vs. 10±1.18 cm and 163±37.4 ml vs. 149.6±36.8 ml, respectively. The mean difference between L and R lengths and volumes were 0.49 ± 1.21 cm and 12.43 ± 22.33 ml. The accuracy, correlation, site of nephrectomy is shown in Table 1 and Figure 1. 19% of the SRF showed >10% difference in function. 63% of smaller kidneys had lower kidney function while 33% had higher kidney function.

Table 1
	LP	VP	SRF (L%-R%)
Mean ± SD	105.8±12.6	110.4±14.5	1.2±8.9
Accuracy (within % of SRF)
10%	39	14
10-20%	51	79
>20%	10	7
Correlation (r), (p-value)	0.17 (0.093)	0.77 (<0.001)	1
R nephrectomy (SRF performed)	21.3%, p-value=0.015
R nephrectomy (SRF not required)	13.4%, p-value=0.318

Conclusion: CT kidney volumes correlate better with SFR than with CT lengths. SRF is helpful in identifying lower functioning kidneys for donation.

To cite this abstract in AMA style:

Fernandez S, Mohan S, Zaky Z, Crew J, Dube J, Carrol M, Wexler J, Ratner L, Cohen D, Tanriover B. Relationship of Kidney Length, Volume and Renal Split Function in Living Kidney Donors [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/relationship-of-kidney-length-volume-and-renal-split-function-in-living-kidney-donors/. Accessed November 23, 2024.

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