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Usefulness of multi-detector computed tomography (MDCT) scanning as a replacement for diethylenetriamine pentaacetic acid (DTPA)

Authors
 H.H. Lee  ;  W.K. Han  ;  S.K. Kang  ;  K.H. Huh  ;  M.S. Kim  ;  S.I. Kim  ;  Y.S. Kim  ;  Y.E. Yoon 
Citation
 Transplantation Proceedings, Vol.49(5) : 1023-1026, 2017 
Journal Title
 Transplantation Proceedings 
ISSN
 0041-1345 
Issue Date
2017
MeSH
Adult ; Female ; Glomerular Filtration Rate* ; Humans ; Kidney/diagnostic imaging ; Kidney/physiopathology ; Kidney Transplantation ; Living Donors* ; Male ; Middle Aged ; Multidetector Computed Tomography/methods* ; Nephrectomy ; Pentetic Acid* ; Polyamines ; Postoperative Complications* ; Postoperative Period ; Predictive Value of Tests ; ROC Curve ; Renal Insufficiency, Chronic/diagnostic imaging* ; Renal Insufficiency, Chronic/physiopathology ; Tissue and Organ Harvesting/adverse effects*
Abstract
BACKGROUND: Diethylenetriamine pentaacetic acid (DTPA) and multi-detector computed tomography (MDCT) can predict postoperative estimated glomerular filtration rate (eGFR) in a live kidney donor. Accordingly, we compared predicted eGFR measured by use of DTPA and MDCT. METHODS: From January 2013 to May 2015, 264 live kidney donors were enrolled. All donors underwent preoperative DTPA and MDCT, and bilateral renal cortex volume was measured by use of MDCT. We estimated DTPA-eGFR [remaining split renal function (%) × preoperative eGFR] and Vol-eGFR [remaining renal volume/total renal volume (%) × preoperative eGFR] and analyzed DTPA-eGFR, Vol-eGFR, and Modification of Diet in Renal Disease (MDRD)-eGFR during week 1 and in months 1, 3, and 6. Additionally, we compared DTPA-eGFR and Vol-eGFR by use of the formula ΔeGFR (maximum eGFR minus minimum eGFR during 6 months). RESULTS: The mean DTPA-eGFR and Vol-eGFR values (mL/min/1.73 m2) were 52.97 ± 10.32 and 51.26 ± 10.26, respectively. Predictions of the dominant side did not agree in 113 of 303 (37.3%) cases. Postoperative MDRD-eGFR exhibited a statistically significant correlation with total renal volume, DTPA-eGFR, and Vol-eGFR (P < .0001). A significant correlation was found between ΔeGFR and total renal volume, DTPA-eGFR, and Vol-eGFR (P < .0001). Receiver operating characteristic curves were generated to predict the possibility of eGFR <60 mL/min/1.73 m2 at 6 months, using DTPA-eGFR and Vol-eGFR, which indicated that DTPA-eGFR (area under the curve = 0.858; P < .0001) and Vol-eGFR (area under the curve = 0.878; P < .0001) could predict chronic kidney disease class III at 6 months. CONCLUSIONS: MDRD-eGFR, Vol-eGFR, and DTPA-eGFR were significantly correlated. Moreover, Vol-eGFR and DTPA-eGFR exhibited high predictive value for chronic kidney disease class III at 6 months, whereas Vol-eGFR was a good predictor of renal function recovery.
Full Text
https://www.sciencedirect.com/science/article/pii/S0041134517302762
DOI
10.1016/j.transproceed.2017.03.056
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
강숭구(Kang, Sung Ku) ORCID logo https://orcid.org/0000-0002-3143-507X
김명수(Kim, Myung Soo)
김순일(Kim, Soon Il) ORCID logo https://orcid.org/0000-0002-0783-7538
김유선(Kim, Yu Seun) ORCID logo https://orcid.org/0000-0002-5105-1567
윤영은(Yoon, Young Eun)
이형호(Lee, Hyung Ho)
한웅규(Han, Woong Kyu) ORCID logo https://orcid.org/0000-0002-2527-4046
허규하(Huh, Kyu Ha) ORCID logo https://orcid.org/0000-0003-1364-6989
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160343
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