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

PLoS One. 2021 Jul 2;16(7):e0253609. doi: 10.1371/journal.pone.0253609. eCollection 2021.

Abstract

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.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology
  • Humans
  • Kidney / diagnostic imaging
  • Kidney / physiology*
  • Kidney Function Tests / methods
  • Kidney Function Tests / statistics & numerical data
  • Kidney Transplantation*
  • Living Donors / statistics & numerical data*
  • Male
  • Middle Aged
  • Nephrectomy / adverse effects*
  • Postoperative Period
  • Radioisotope Renography / statistics & numerical data
  • Retrospective Studies
  • Tissue and Organ Harvesting / adverse effects*
  • Tomography, X-Ray Computed / statistics & numerical data

Grants and funding

The authors received no specific funding for this work.