CT-measured Cortical Volume Ratio Is an Accurate Alternative to Nuclear Medicine Split Scan Ratio Among Living Kidney Donors.
CT-measured Cortical Volume Ratio Is an Accurate Alternative to Nuclear Medicine Split Scan Ratio Among Living Kidney Donors.
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CT 测量的皮质体积比是活体肾脏捐赠者中核医学分裂扫描比的准确替代方案。
DOI：
10.1097/tp.0000000000003676
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发表时间：
2021
期刊：
影响因子：
6.2
通讯作者：
Woodside,KennethJ
中科院分区：
文献类型：
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作者：
Montgomery,JohnR;Brown,CraigS;Zondlak,AllyseN;Walsh,KevinW;Kozlowski,JuliaE;Pinsky,AlexaM;Herriman,EmilyA;Sussman,Jeremy;Lu,Yee;Stein,EricaB;Shankar,PrasadR;Sung,RandallS;Woodside,KennethJ
背景：125I-碘酞酸清除率和99mTc-二乙烯三胺-五乙酸（99mTc-DTPA）分裂扫描核医学研究在活体肾供体候选者中用于确定测量的肾小球滤过率（mGFR）和分裂扫描比率（SSR）。计算机断层扫描衍生的皮质体积比（CVR）是一种新的测量劈裂肾功能的方法，可以与捐赠前估计的GFR（eGFR）或mGFR相结合，以预测捐赠后肾功能。捐赠前SSR是否比捐赠前CVR更好地预测捐赠后肾功能，以及捐赠前mGFR是否提供了捐赠前eGFR之外的额外信息尚不清楚。方法：我们对2015年6月至2019年3月期间接受肾脏捐赠的204例患者进行了单中心回顾性分析。主要结果是捐赠后1年的eGFR。模型基础由捐献前肾功能（mGFR或eGFR）的测量值乘以每个非捐献肾脏对捐献前肾功能（SSR或CVR）的贡献比例创建。采用1000次重复的多变量弹性网络回归分析，确定模型间R2、均方根误差（RMSE）和超预测率≥ 15mL/min/1.73m2的平均值和95%可信区间（R2，0.547; RMSE，9.2mL/min/1.73m2，比例高估3.1%），而mGFR-SSR模型表现最差（R2，0.360; RMSE为10.9mL/min/1.73m2，比例高估7.2%）（所有比较P <0.001）结论：这些发现表明，在供体评估期间，捐赠前CVR可以作为SSR的可接受的替代方案，基于CVR和捐赠前eGFR的模型可能优于其他方法，这是上级。
Background.The 125 I-iothalamate clearance and 99m Tc diethylenetriamine-pentaacetic acid (99m Tc-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 R 2, root mean square error (RMSE), and proportion overprediction≥ 15 mL/min/1.73 m 2 between models.Results.In validation cohorts, eGFR-CVR models performed best (R 2, 0.547; RMSE, 9.2 mL/min/1.73 m 2, proportion overprediction 3.1%), whereas mGFR-SSR models performed worst (R 2, 0.360; RMSE, 10.9 mL/min/1.73 m 2, proportion overprediction 7.2%)(P< 0.001 for all comparisons).Conclusions.These findings suggest that predonation CVR may serve as an acceptable alternative to SSR during donor evaluation and furthermore, that a model based on CVR and predonation eGFR may be superior to other methods.