scholarly journals Remnant renal volume can predict prognosis of remnant renal function in kidney transplantation donors: a prospective observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shunta Hori ◽  
Nobumichi Tanaka ◽  
Tatsuo Yoneda ◽  
Nobutaka Nishimura ◽  
Mitsuru Tomizawa ◽  
...  
Keyword(s):  
Renal Function ◽  
Prospective Observational Study ◽  
Estimated Glomerular Filtration Rate ◽  
Donor Nephrectomy ◽  
Image Analysis System ◽  
Renal Volume ◽  
Living Kidney Donors ◽  
Analysis System ◽  
Computed Tomography Volumetry

Abstract Background Safety and survival during and after donor nephrectomy (DN) are one of the main concerns in living kidney donors (LKDs). Therefore, kidney (left/right) to be procured should be determined after considering the difficulty of DN, as well as the preservation of remnant renal function (RRF). In this prospective study, we investigated the roles of computed tomography volumetry (CTV) in split renal function (SRF) and established a predictive model for RRF in LKDs. Methods We assessed 103 LKDs who underwent DN at our institute. The Volume Analyzer SYNAPSE VINCENT image analysis system were used as CTV. RRF was defined as the estimated glomerular filtration rate (eGFR) 12 months after DN. The association between various factors measured by CTV and RRF were investigated, and a role of CTV on prediction for RRF was assessed. Results The median age and the preoperative eGFR were 58 years and 80.7 mL/min/1.73m2, respectively. Each factor measured by CTV showed an association with RRF. The ratio of remnant renal volume to body surface area (RRV/BSA) could predict RRF. In addition, RRV/BSA could predict RRF more accurately when used together with age and 24-h creatinine clearance (CrCl). Conclusions Our findings suggest that RRV/BSA measured by CTV can play an important role in predicting RRF, and a comprehensive assessment including age and CrCl is important to determine the kidney to be procured.

The potential role of the eGFR in differentiating between true and pseudohyperkalaemia

2020 ◽  
Vol 57 (6) ◽  
pp. 444-455
Author(s):  
Thomas G Morris ◽  
Sushmita Lamba ◽  
Thomas Fitzgerald ◽  
Gary Roulston ◽  
Helen Johnstone ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Blood Count ◽  
Potential Role ◽  
Estimated Glomerular Filtration Rate ◽  
Full Blood Count ◽  
Cut Points

Background Differentiating between true and pseudohyperkalaemia is essential for patient management. The common causes of pseudohyperkalaemia include haemolysis, blood cell dyscrasias and EDTA contamination. One approach to differentiate between them is by checking the renal function, as it is believed that true hyperkalaemia is rare with normal function. This is logical, but there is limited published evidence to support it. The aim of this study was to investigate the potential role of the estimated glomerular filtration rate in differentiating true from pseudohyperkalaemia. Methods GP serum potassium results >6.0 mmol/L from 1 January 2017 to 31 December 2017, with a repeat within seven days, were included. Entries were retrospectively classified as true or pseudohyperkalaemia based on the potassium reference change value and reference interval. If the initial sample had a full blood count, it was classified as normal/abnormal to remove blood cell dyscrasias. Different estimated glomerular filtration rate cut-points were used to determine the potential in differentiating true from pseudohyperkalaemia. Results A total of 272 patients were included with potassium results >6.0 mmol/L, with 145 classified as pseudohyperkalaemia. At an estimated glomerular filtration rate of 90 ml/min/1.73 m2, the negative predictive value was 81% (95% CI: 67–90%); this increased to 86% (95% CI: 66–95%) by removing patients with abnormal full blood counts. When only patients with an initial potassium ≥6.5 mmol/L were included (regardless of full blood count), at an estimated glomerular filtration rate of 90 ml/min/1.73 m2, the negative predictive value was 100%. Lower negative predictive values were seen with decreasing estimated glomerular filtration rate cut-points. Conclusion Normal renal function was not associated with true hyperkalaemia, making the estimated glomerular filtration rate a useful tool in predicting true from pseudohyperkalaemia, especially for potassium results ≥6.5 mmol/L.

scholarly journals P0845INCREASING TOTAL RENAL VOLUME AFTER NEPHRECTOMY FOR RENAL CELL CARCINOMA IS ASSOCIATED WITH RENAL FUNCTION EVOLUTION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
SAUL PAMPA-SAICO ◽  
M Soledad Pizarro-Sánchez ◽  
Simona Alexandru ◽  
Laura García Puente-Suárez ◽  
María López-Picasso ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Function ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Renal Volume

Abstract Background and Aims Renal cell carcinoma is the most common form of kidney cancer. Reduction of renal mass after radical nephrectomy (RN) in these patients, results in compensatory hypertrophy of the contralateral kidney. The capacity of compensation will determine the renal function (RF) evolution. Measuring of total renal volume (TRV) of the remaining kidney pre and post RN can help assess the RF evolution. Aims To determine the correlation between TRV pre and post nephrectomy (a year of follow-up) with RF and the factors that modify. Method A retrospective cohort study was carried out in our institution, in 62 patients who had underwent RN from 2014 to 2018, due to renal cell carcinoma (confirmed by histopathology). The demographic data included age, gender, body mass index (BMI), associated comorbidities, smoking habits were collected. Serum creatinine, estimated glomerular filtration rate (eGFR) and proteinuria were collected in the preoperative period and in the follow-up. The TRV was calculated pre and post (a year of follow-up) RN, using ellipsoid formula equation (computed tomography scan or magnetic resonance imaging). Renal function evolution was assessed by eGFR using the modification of diet in Renal Disease formula. Multivariate linear regression analysis was used to determine the predictor of TRV at 1 year of follow-up. Results The median age at the time of RN was 71 years old (range, 43-86 years). Most of them were men, 69% (43/19). The estimated glomerular filtration rate (FGe) pre and post nephrectomy was 74 (41-102) and 52.1 ml/min/ m2 (22-89) respectively (P=0.013). The TRV pre and post-nephrectomy was 165.3 (102.3-259.7) and 188.3 ml (115.3-271.2) respectively (P=0.001). On multivariate linear regression analysis, controlling for age and sex; the pre-nephrectomy FGe (β = 0.42; P = 0.023) and the pre TRV (β = 1.23; P <0.0001) were positively correlated with the post-nephrectomy TRV, while the FGe at year of follow-up was correlated negatively (β = -1.11; P = 0.024) Conclusion The post nephrectomy TRV was positively correlated with TRV and FGe pre nephrectomy. While with the FGe at one year post nephrectomy was negatively correlated. The increasing TRV pre and post nephrectomy can help to predict renal function at a year of follow-up in this group of patients.

Catching up with the past: historians, pictures and PCs

1998 ◽  
Vol 10 (1-3) ◽  
pp. 120-123
Author(s):  
Andrew Sawyer
Keyword(s):  
Historical Study ◽  
Image Analysis System ◽  
The Past ◽  
Catching Up ◽  
Textual Data ◽  
Video And Audio ◽  
Analysis System ◽  
The Impact ◽  
Theoretical Issues

Sources such as imagery and video and audio material are increasing being adopted in an evidential, rather than an allusive role by historians seeking to exploit them alongside the ‘textual’ data traditionally used. The role of computers in enabling this development has been significant, in enabling greater access to such sources (via CD and online collections, for example) an in providing tools for the analysis of novel sources (such as KLEIO Image Analysis System). At the same time the impact of ‘postmodernity’ upon the study of history has led to a growth in interest in theoretical issues which challenge many of the assumptions upon which the discipline is based. This paper addresses those issues from the narrower perspective – that gained during a detailed historical study of political prints produced during the late 16th and early 17th centuries, which have been digitally modelled, and analysed using KLEIO IAS. It suggests that in adopting less traditional sources, the nature of those sources and methodological shifts they impose will render it imperative for historians to engage with theoretical issues raised by postmodernity.

Visceral obesity in Asian living kidney donors significantly impacts early renal function after donor nephrectomy

2018 ◽  
Vol 37 (10) ◽  
pp. 2231-2236 ◽  
Author(s):  
Gregory Xiang Wen Pek ◽  
Clara Lee Ying Ngoh ◽  
Boon Wee Teo ◽  
Anantharaman Vathsala ◽  
Benjamin Yen Seow Goh ◽  
...  
Keyword(s):  
Renal Function ◽  
Visceral Obesity ◽  
Donor Nephrectomy ◽  
Kidney Donors ◽  
Living Kidney Donors

2271 DOES PRESERVED RENAL VOLUME PREDICT 1-YEAR DONOR RENAL FUNCTION FOLLOWING LIVING DONOR NEPHRECTOMY?

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Rachid Yakoubi ◽  
Riccardo Autorino ◽  
Ahmad Kassab ◽  
Humberto K. Laydner ◽  
Shahab Hillyer ◽  
...  
Keyword(s):  
Renal Function ◽  
Living Donor ◽  
Donor Nephrectomy ◽  
Renal Volume ◽  
Living Donor Nephrectomy

scholarly journals Factors related to suboptimal recovery of renal function after living donor nephrectomy: a retrospective study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sho Nishida ◽  
Yuji Hidaka ◽  
Mariko Toyoda ◽  
Kohei Kinoshita ◽  
Kosuke Tanaka ◽  
...  
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Estimated Glomerular Filtration Rate ◽  
Compensatory Hypertrophy ◽  
Donor Nephrectomy ◽  
Donor Age ◽  
Living Donor Nephrectomy ◽  
Independent Risk Factors ◽  
Renal Transplantations ◽  
Group 1

Abstract Background The renal function of the remaining kidney in living donors recovers up to 60~70% of pre-donation estimated-glomerular filtration rate (eGFR) by compensatory hypertrophy. However, the degree of this hypertrophy varies from donor to donor and the factors related to it are scarcely known. Methods We analyzed 103 living renal transplantations in our institution and divided them into two groups: compensatory hypertrophy group [optimal group, 1-year eGFR ≥60% of pre-donation, n = 63] and suboptimal compensatory hypertrophy group (suboptimal group, 1-year eGFR < 60% of pre-donation, n = 40). We retrospectively analyzed the factors related to suboptimal compensatory hypertrophy. Results Baseline eGFRs were the same in the two groups (optimal versus suboptimal: 82.0 ± 13.1 ml/min/1.73m2 versus 83.5 ± 14.8 ml/min/1.73m2, p = 0.588). Donor age (optimal versus suboptimal: 56.0 ± 10.4 years old versus 60.7 ± 8.7 years old, p = 0.018) and uric acid (optimal versus suboptimal: 4.8 ± 1.2 mg/dl versus 5.5 ± 1.3 mg/dl, p = 0.007) were significantly higher in the suboptimal group. The rate of pathological chronicity finding on 1-h biopsy (ah≧1 ∩ ct + ci≧1) was much higher in the suboptimal group (optimal versus suboptimal: 6.4% versus 25.0%, p = 0.007). After the multivariate analysis, the pathological chronicity finding [odds ratio (OR): 4.8, 95% confidence interval (CI): 1.3–17.8, p = 0.021] and uric acid (per 1.0 mg/dl, OR: 1.5, 95% CI: 1.1–2.2, p = 0.022) were found to be independent risk factors for suboptimal compensatory hypertrophy. Conclusion Chronicity findings on baseline biopsy and higher uric acid were associated with insufficient recovery of the post-donated renal function.

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