3D Renal Parenchymal Volume as a Surrogate for Renal Function Estimation in Obstructed Kidneys Undergoing Surgical Repair Journal Article

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Authors: Martinez-Suarez, H. J.; Durso, T.; Kadlec, A. O.; Gupta, G. N.; Farooq, A. V.; Turk, T
Article Title: 3D Renal Parenchymal Volume as a Surrogate for Renal Function Estimation in Obstructed Kidneys Undergoing Surgical Repair
Abstract: Purpose: To investigate the relationship between renal parenchymal volume (RPV) and renal function in obstructed kidneys using a novel 3D volume-rendering technique. Materials and Methods: 47 consecutive patients who underwent pyeloplasty, ureteroureterostomy, or ureteroneocystostomy at a single institution between 2007 and 2013 were reviewed. Patients with preoperative CT scan and split differential functional (SDF) assessment by diuretic renography were included. Those with solitary kidneys and bilateral obstruction were excluded. Baseline serum creatinineand eGFR as calculated by the MDRD equation were determined. Percent of total RPV for the obstructed kidney was determined using 3D-reconstruction software by drawing regions of interest around the borders of the kidney on CT. The renal pelvis, hilar vessels, and hilar fat were excluded. Percent of total RPV was then correlated with SDF. Results: 19 patients with both preoperative CT and diuretic renal scans and were included. Two underwent ureteroneocystostomy, one underwent ureteroureterostomy, 16 underwent pyeloplasty. Mean serum Cr was 1.07mg/dL +/- 0.26 with a mean eGFR of 69.43mL/min +/- 18.90. Mean SDF was 37.32% +/- 11.66 in the obstructed kidneys. There was a statistically significant correlation between percent of total RPV and SDF (R2=0.28, p=0.02). Conclusions: There is a significant correlation between percent total RPV determined by 3D reconstruction of CT scan images and SDF as determined by diuretic renography in obstructed kidneys. CT-based percent RPV has potential as a functional assessment tool in obstructed kidneys. With further validation, it may be used to counsel patients considering surgical repair of ureteral or ureteropelvic junction obstruction.
Journal Title: Journal of endourology / Endourological Society
ISSN: 1557-900X; 0892-7790
Publisher: Unknown  
Date Published: 2014
Language: ENG
DOI/URL:

10.1089/end.2014.0232.ECC
Notes: LR: 20141022; JID: 8807503; aheadofprint