Assessment of Split Renal Function Using a Combination of Contrast-Enhanced CT and Serum Creatinine Values for Glomerular Filtration Rate Estimation

Shi, Wenwei; Xiao, Liang; Wu, Ning; Zhang, Hui; Yuan, Xiaoyang; Tan, Yan

doi:10.2214/ajr.19.22125

“…Although not performed in this case, methods such as renal nuclear scintigraphy and CTbased volumetry with assessment of contrast attenuation can be used to definitively determine the relative contribution of each kidney to overall glomerular filtration rate. 15,16 Renal artery involvement in acute descending aortic dissection is relatively common, with reported renal artery involvement and impaired renal perfusion in 8% to 16% depending on the dissection type and detection modality, with sensitivity increased with modern imaging techniques. 17,18 The risk of morbidity and mortality is increased in patients with acute kidney injury, associated with 5% to 10% in-hospital mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Although not performed in this case, methods such as renal nuclear scintigraphy and CT-based volumetry with assessment of contrast attenuation can be used to definitively determine the relative contribution of each kidney to overall glomerular filtration rate. 15,16…”

Section: Discussionmentioning

confidence: 99%

Flow Disturbances: Competing Interests in a Case of Hypertensive Emergency

Alexander,

Aday,

Lewis

et al. 2024

Hypertension

0

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“…Radionuclide scanning can assess the patients' renal blood flow perfusion, GFR of the total and split kidneys, upper urinary tract patency, and other comprehensive information, but this diagnostic technique is radiological and cannot be manipulated repeatedly [ 17 ]. Some scholars believe [ 18 ] that the CDFQ diagnostic technique can be used for splanchnic blood perfusion assessment, which is a new diagnostic method formed based on the conventional two-dimensional ultrasound and color Doppler technology and can quantitatively assess renal blood perfusion by using professional software analysis, which is easy, quick, inexpensive, and can be reused multiple times [ 19 , 20 ]. However, 640-slice volume CT can precisely localize the renal lesions in patients and has diagnostic advantages such as high resolution and multislice imaging, as well as rapid detection of renal tumor lymph node metastasis and signs such as infiltration and deep venous tumor thrombus, but the inability of dynamic observation as well as radiopacity make its clinical application limited [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Application Value for Diagnosis of Chronic Kidney Disease between Color Doppler Flow Quantification Technique and Computed Tomography

Zhao

¹

,

Zhang

²

,

Wang

³

et al. 2022

Contrast Media & Molecular Imaging

1

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Objective. The aim of this study is to compare the application value for diagnosis of chronic kidney disease (CKD) between the color Doppler flow quantification (CDFQ) technique and computed tomography (CT). Methods. The clinical data of 88 hospitalized patients treated in the Renal Medicine of our hospital and diagnosed with CKD after pathological examination from June 2020 to June 2021 were selected for the retrospective analysis, and 32 individuals with normal physical examination results in the same period were selected as the control group. All study subjects received CDFQ and 640-slice volume CT examination, and by plotting the ROC curves, the clinical value of different diagnostic modalities was analyzed. Results. The 3D renal volumes between the stage 1 group and control group were significantly different P < 0.05 ; the 3D renal volumes between the stage 2 group and control group and between the stage 2 group and stage 1 group were significantly different P < 0.05 ; in the comparison between the stage 3 group versus control group/stage 2 group, the RI values, 3D renal volumes, and cortical thicknesses were significantly different P < 0.05 ; in the comparison between the stage 4 group versus control group/stage 1 group, the RI values, 3D renal volumes, and cortical thicknesses were significantly different, and between the stage 4 group and stage 2 group, the RI values and cortical thicknesses were significantly different P < 0.05 ; in the comparison between the stage 5 group versus control group/stage 1 group/stage 2 group/stage 3 group, the RI values, 3D renal volumes, and cortical thicknesses were significantly different, and between the stage 5 group and stage 4 group, the RI values and 3D renal volumes were significantly different P < 0.05 ; among various groups, the measurement indicators of 640-slice volume CT scan were significantly different P < 0.05 ; and in terms of disease classification, the AUC value, positive predictive value, negative predictive value, sensitivity, and specificity of 640-slice volume CT were higher than those of CDFQ diagnosis. Conclusion. 640-slice volume CT has a higher efficacy in diagnosing CKD and can provide a reliable basis for the selection of treatment schemes for CKD patients.

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“…Strengths of our study include data derived from a large, non-selected donor cohort as all donor candidates had nuclear renography, and the performance of inter-rater agreement (having 2 independent assessors), which many studies did not examine for the consideration of reproducibility [9][10][11]13,14,21]. Studies that pre-select donor populations based on imaging results may be biased towards increased likelihood of finding a greater than 1 cm difference in kidney length and therefore discrepant split kidney function, whereas our study includes all consecutive donors since renography was performed for all donors in the program [14,17,[22][23][24].…”

Section: Plos Onementioning

confidence: 99%

“…split kidney function) only in patients with a difference in kidney length exceeding 1 cm on CT [7,8]. However, it is unclear if this method alone should be adopted by all individual donor programs given the lack of long term data on their ability to predict post-donation remaining kidney function [9][10][11][12][13][14]. This is of particular concern for donors with a clinically significant difference in split kidney function on renography that is missed on CT and donors with low eGFR after donation.…”

Section: Introductionmentioning

confidence: 99%

The impact of measuring split kidney function on post-donation kidney function: A retrospective cohort study

Harper

¹

,

Salameh

²

,

Akhlaq

³

et al. 2021

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Background Studies have reported agreement between computed tomography (CT) and renography for the determination of split kidney function. However, their correlation with post-donation kidney function remains unclear. We compared CT measurements with renography in assessment of split kidney function (SKF) and their correlations with post-donation kidney function. Methods A single-centre, retrospective cohort study of 248 donors from January 1, 2009-July 31, 2019 were assessed. Pearson correlations were used to assess post-donation kidney function with renography and CT-based measurements. Furthermore, we examined high risk groups with SKF difference greater than 10% on renography and donors with post-donation eGFR less than 60 mL/min/1.73m2. Results 62% of donors were women with a mean (standard deviation) pre-donation eGFR 99 (20) and post-donation eGFR 67 (22) mL/min/1.73m2 at 31 months of follow-up. Post-donation kidney function was poorly correlated with both CT-based measurements and renography, including the subgroup of donors with post-donation eGFR less than 60 mL/min/1.73m2 (r less than 0.4 for all). There was agreement between CT-based measurements and renography for SKF determination (Bland-Altman agreement [bias, 95% limits of agreement] for renography vs: CT volume, 0.76%, -7.60–9.15%; modified ellipsoid,1.01%, -8.38–10.42%; CC dimension, 0.44%, -7.06–7.94); however, CT missed SKF greater than 10% found by renography in 20 out 26 (77%) of donors. Conclusions In a single centre study of 248 living donors, we found no correlation between CT or renography and post-donation eGFR. Further research is needed to determine optimal ways to predict remaining kidney function after donation.

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Assessment of Split Renal Function Using a Combination of Contrast-Enhanced CT and Serum Creatinine Values for Glomerular Filtration Rate Estimation

Cited by 12 publications

References 23 publications

Flow Disturbances: Competing Interests in a Case of Hypertensive Emergency

Flow Disturbances: Competing Interests in a Case of Hypertensive Emergency

Comparison of the Application Value for Diagnosis of Chronic Kidney Disease between Color Doppler Flow Quantification Technique and Computed Tomography

The impact of measuring split kidney function on post-donation kidney function: A retrospective cohort study

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