Ratio of donor kidney weight to recipient bodyweight as an index of graft function

Kim, Yu Seun; Moon, Jeong Mi; Kim, Dong Kee; Kim, Soon Il; Park, Kiil

doi:10.1016/s0140-6736(00)04377-4

Cited by 78 publications

(57 citation statements)

References 3 publications

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“…For instance, a reduction can occur in chronic kidney disease and is a frequently used parameter for decisions about biopsy, whereas renal enlargement can occur in a number of disorders. Renal enlargement in diabetics is a risk factor for nephropathy (1,2), and the size of donor kidneys influences the outcome after transplantation (3)(4)(5). A reduced quantity of nephrons at birth may contribute to the development of hypertension (6,7) and may be detectable as differences in renal parenchymal volume because kidney weight correlates closely with nephron number (8) in healthy humans.…”

Section: Introductionmentioning

confidence: 99%

Determinants and Functional Significance of Renal Parenchymal Volume in Adults

Johnson

Rishi

Andone

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives The significance of renal parenchymal volume and the factors that influence it are poorly understood.Design, setting, participants, & measurements Renal parenchymal volume (RPV) was measured on contrastenhanced CT scans after exclusion of sinus fat and vessels in 224 healthy subjects evaluated as kidney donors and in a separate cohort of 22 severely obese individuals before and after 6 months of weight loss. GFR was measured by iohexol clearance in 76 of the transplant donors. RPV was correlated with age, GFR, and various anthropometric parameters. ResultsIn potential transplant donors, RPV correlated with body surface area (BSA; r ϭ 0.68) and was 7% larger in men but did not vary with age or race. Gender and body size were independent determinants of RPV. RPV correlated well with GFR (r ϭ 0.62) and accounted for almost all of the variability in a model of GFR that included age, race, gender, and body surface area. GFR correlated more strongly with RPV than with creatinine-based equations. The same relationship between RPV and BSA was observed in obesity, and RPV decreased with weight loss. ConclusionsIn healthy adults younger than 65 years, renal parenchymal volume is governed by body size and gender but not age or race and is strongly correlated with GFR. This indicates that renal parenchymal volume varies to meet metabolic demand and is closely linked to renal function.

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Section: Introductionmentioning

confidence: 99%

Determinants and Functional Significance of Renal Parenchymal Volume in Adults

Johnson

Rishi

Andone

et al. 2011

Clinical Journal of the American Society of Nephrology

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“…7,16 -19 The effect of kidney graft size and recipient weight (Rw) 20,21 has also been studied; however, the direct impact of matching the Kw itself (which correlates with both glomerular volume and nephron number) 15 to the Rw has been studied only in relatively small cohorts of Ͻ300 patients and only in living donors, 22,23 where the graft does not incur the same accumulating injuries as those from deceased donors.…”

mentioning

confidence: 99%

Kidney and Recipient Weight Incompatibility Reduces Long-Term Graft Survival

Giral¹,

Foucher²,

Karam³

et al. 2010

Journal of the American Society of Nephrology

117

102

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Long-term function of kidney allografts depends on multiple variables, one of which may be the compatibility in size between the graft and the recipient. Here, we assessed the long-term consequences of the ratio of the weight of the kidney to the weight of the recipient (KwRw ratio) in a multicenter cohort of 1189 patients who received a transplant between 1995 and 2006. The graft filtration rate increased by a mean of 5.74 ml/min between the third and sixth posttransplantation months among patients with a low KwRw ratio (Ͻ2.3 g/kg; P Ͻ 0.0001). In this low KwRw ratio group, the graft filtration rate remained stable between 6 months and 7 years but then decreased at a mean rate of 3.17 ml/min per yr (P Ͻ 0.0001). In addition, low KwRw ratios conferred greater risk for proteinuria, more antihypertensive drugs, and segmental or global glomerulosclerosis. Moreover, a KwRw ratio Ͻ2.3 g/kg associated with a 55% increased risk for transplant failure by 2 years of follow-up. In conclusion, incompatibility between graft and recipient weight is an independent predictor of long-term graft survival, suggesting that avoiding kidney and recipient weight incompatibility may improve late clinical outcome after kidney transplantation.

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“…There is a consensus about kidney size being related to body height, body surface area, and to some extent also to body weight (15,30). However, the highest correlation coefficient was with lean body mass.…”

Section: Discussionmentioning

confidence: 99%

“…To date, scientists have documented several factors that contribute to this variation. Factors related to kidney growth, such as gender and physical size, affect the maximal size of an individual's kidney (15,16,23,30). Comparing solely the kidney volumes between two groups (i.e.…”

Section: Introductionmentioning

confidence: 99%

The volume fraction method for the evaluation of kidney: A stereological study

Pazvant¹,

Şahin²,

Kahvecioğlu³

et al. 2009

Ankara Üniversitesi Veteriner Fakültesi Dergisi

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Summary:It is known that the kidney size is related to body height, body surface area and body weight. In the present study we propose the volume fraction approach of stereological methods that eliminate the effects of body size over the quantitative evaluation of cortex, medulla and pelvis of kidney. Kidneys were removed from 20 Kivircik sheeps and their volumes were measured using the Archimedean principle. The total volume and volume of its components and the volume fraction of cortex, medulla and the pelvis were estimated stereologically. The mean kidney volumes were 61.3±12.7cm 3 and 59.7±12.8cm 3 , using the Archimedean and the Cavalieri principles, respectively. The obtained values were not found to be significantly different (p>0.05). The kidney was composed of 69.7±3.0% cortex, 27.1±2.9% medulla and 3.2±0.7% pelvis. Our results show that the stereological method applied in this study provides unbiased data about the volumetric characteristics of kidney and can be used on physical section of the evaluation of the volume and volume fractions of kidney and its subcomponents.Key words: Cavalieri principle, renal cortex, renal medulla, renal pelvis, stereology Böbrek değerlendirmesi için hacimsel oran metodu: Stereolojik çalışmaÖzet: Böbrek büyüklüğünün, vücut yüksekliği, vücut yüzey alanı ve vücut ağırlığı ile ilişkili olduğu bilinmektedir. Yapılan bu çalışmada, korteks, medulla ve böbrek pelvisinin rakamsal değerlendirilmesi üzerinde vücut büyüklüğünün etkilerini elimine etmek amacı ile, stereolojik metodlardan hacimsel oran yaklaşımı kullanılmıştır. Materyal olarak 20 adet Kıvırcık koyunundan elde edilen böbreklerin hacmi Arşimed prensibi kullanılarak ölçülmüştür. Ayrıca bu böbreklerin toplam hacmi ve korteks, medulla ve pelvis bölümlerinin hacmi stereolojik olarak tahmin edilmiştir. Arşimed ve Cavalier metodları kullanılarak elde edilen ortalama böbrek hacimleri sırası ile, 61.3±12.7 cm 3 ve 59.7±12.8 cm 3 olarak ölçülmüştür. Elde edilen veriler istatistiki olarak önemli bulunmamıştır (p>0,05). Böbrek, %69.7±3.0 korteks, %27.1±2.9 medulla ve %3.2±0.7 pelvis'den oluşmaktadır. Sonuçlarımız gösterir ki, bu çalışmada kullanılan stereolojik metodlar, böbreğin hacimsel karakteristikleri hakkında ön yargısız bilgi sağlar ve böbrek hacmi, hacimsel oranları ve alt bölümlerinin değerlendirilmesinde kullanılabilir.

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Ratio of donor kidney weight to recipient bodyweight as an index of graft function

Cited by 78 publications

References 3 publications

Determinants and Functional Significance of Renal Parenchymal Volume in Adults

Determinants and Functional Significance of Renal Parenchymal Volume in Adults

Kidney and Recipient Weight Incompatibility Reduces Long-Term Graft Survival

The volume fraction method for the evaluation of kidney: A stereological study

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