1. CT-measured Cortical Volume Ratio Is an Accurate Alternative to Nuclear Medicine Split Scan Ratio Among Living Kidney Donors
- Author
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Erica B. Stein, John R. Montgomery, Allyse N. Zondlak, Kenneth J. Woodside, Emily A. Herriman, Jeremy B. Sussman, Yee Lu, Craig S. Brown, Julia E. Kozlowski, Alexa M. Pinsky, Prasad R. Shankar, Randall S. Sung, and Kevin Walsh
- Subjects
Transplantation ,Kidney ,business.industry ,Kidney donation ,Renal function ,Kidney Transplantation ,Cortical volume ,Confidence interval ,Iodine Radioisotopes ,medicine.anatomical_structure ,Primary outcome ,Living Donors ,Retrospective analysis ,Humans ,Medicine ,DONOR EVALUATION ,Nuclear Medicine ,Tomography, X-Ray Computed ,business ,Nuclear medicine ,Glomerular Filtration Rate ,Retrospective Studies - Abstract
BACKGROUND The 125I-iothalamate clearance and 99mTc diethylenetriamine-pentaacetic acid (99mTc-DTPA) split scan nuclear medicine studies are used among living kidney donor candidates to determine measured glomerular filtration rate (mGFR) and split scan ratio (SSR). The computerized tomography-derived cortical volume ratio (CVR) is a novel measurement of split kidney function and can be combined with predonation estimated GFR (eGFR) or mGFR to predict postdonation kidney function. Whether predonation SSR predicts postdonation kidney function better than predonation CVR and whether predonation mGFR provides additional information beyond predonation eGFR are unknown. METHODS We performed a single-center retrospective analysis of 204 patients who underwent kidney donation between June 2015 and March 2019. The primary outcome was 1-y postdonation eGFR. Model bases were created from a measure of predonation kidney function (mGFR or eGFR) multiplied by the proportion that each nondonated kidney contributed to predonation kidney function (SSR or CVR). Multivariable elastic net regression with 1000 repetitions was used to determine the mean and 95% confidence interval of R2, root mean square error (RMSE), and proportion overprediction ≥15 mL/min/1.73 m2 between models. RESULTS In validation cohorts, eGFR-CVR models performed best (R2, 0.547; RMSE, 9.2 mL/min/1.73 m2, proportion overprediction 3.1%), whereas mGFR-SSR models performed worst (R2, 0.360; RMSE, 10.9 mL/min/1.73 m2, proportion overprediction 7.2%) (P
- Published
- 2021
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