Predicting the development of surgically induced chronic kidney disease after total nephrectomy using body surface area-adjusted renal cortical volume on CT angiography

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Abstract

OBJECTIVE. The purpose of this study was to predict the probability of surgically induced chronic kidney disease (CKD) developing in patients who underwent total nephrectomy by measuring the body surface area (BSA)-adjusted renal cortical volume (RCV) with preoperative CT angiography (CTA). MATERIALS AND METHODS. A total of 105 patients with a normal preoperative estimated glomerular filtration rate (eGFR) who underwent preoperative CTA and subsequent total nephrectomy for kidney donation (n = 67) or a renal tumor (n = 38) were included in this retrospective study. Patients were divided into group A (patients without surgically induced CKD; n = 61) and group B (patients with surgically induced CKD; n = 44) according to postoperative renal function. The preoperative and postoperative eGFR and other laboratory findings were collected, and the BSA-adjusted postnephrectomy RCV was measured using a semiautomated segmentation technique on CTA. Multiple logistic regression analysis was used to determine the formula for predicting the probability of development of surgically induced CKD; external validation was conducted using the validation dataset (n = 28). RESULTS. The estimated probability of surgically induced CKD developing can be calculated using the following formula: logit (probability of surgically induced CKD developing) = [1.431 × I (reason for operation was renal tumor)] + (-0.097 × preoperative eGFR) + (-0.033 × BSA-adjusted postnephrectomy RCV) + 10.937, where I denotes an indicator function (I = 1, reason for operation was renal tumor; I = 0, reason for operation was kidney donation). The optimal cutoff value derived from 10,000 bootstrapped samples was 0.444 (95% CI, 0.298-0.681). The formula was determined to be a good tool for prediction of surgically induced CKD on external validation (AUC value, 0.894). CONCLUSION. The probability of CKD developing in patients who undergo total nephrectomy may be predicted using a BSA-adjusted postnephrectomy RCV volume measured on preoperative CTA.

Original languageEnglish
Pages (from-to)W32-W40
JournalAmerican Journal of Roentgenology
Volume212
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

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Cone-Beam Computed Tomography
Body Surface Area
Nephrectomy
Chronic Renal Insufficiency
Kidney
Glomerular Filtration Rate
Computed Tomography Angiography
Neoplasms
Area Under Curve
Retrospective Studies
Logistic Models
Regression Analysis

Keywords

  • Chronic kidney disease
  • CT angiography
  • Kidney transplantation
  • Nephrectomy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{e8089c8b4f6f4cbc8a0e64165cd49627,
title = "Predicting the development of surgically induced chronic kidney disease after total nephrectomy using body surface area-adjusted renal cortical volume on CT angiography",
abstract = "OBJECTIVE. The purpose of this study was to predict the probability of surgically induced chronic kidney disease (CKD) developing in patients who underwent total nephrectomy by measuring the body surface area (BSA)-adjusted renal cortical volume (RCV) with preoperative CT angiography (CTA). MATERIALS AND METHODS. A total of 105 patients with a normal preoperative estimated glomerular filtration rate (eGFR) who underwent preoperative CTA and subsequent total nephrectomy for kidney donation (n = 67) or a renal tumor (n = 38) were included in this retrospective study. Patients were divided into group A (patients without surgically induced CKD; n = 61) and group B (patients with surgically induced CKD; n = 44) according to postoperative renal function. The preoperative and postoperative eGFR and other laboratory findings were collected, and the BSA-adjusted postnephrectomy RCV was measured using a semiautomated segmentation technique on CTA. Multiple logistic regression analysis was used to determine the formula for predicting the probability of development of surgically induced CKD; external validation was conducted using the validation dataset (n = 28). RESULTS. The estimated probability of surgically induced CKD developing can be calculated using the following formula: logit (probability of surgically induced CKD developing) = [1.431 × I (reason for operation was renal tumor)] + (-0.097 × preoperative eGFR) + (-0.033 × BSA-adjusted postnephrectomy RCV) + 10.937, where I denotes an indicator function (I = 1, reason for operation was renal tumor; I = 0, reason for operation was kidney donation). The optimal cutoff value derived from 10,000 bootstrapped samples was 0.444 (95{\%} CI, 0.298-0.681). The formula was determined to be a good tool for prediction of surgically induced CKD on external validation (AUC value, 0.894). CONCLUSION. The probability of CKD developing in patients who undergo total nephrectomy may be predicted using a BSA-adjusted postnephrectomy RCV volume measured on preoperative CTA.",
keywords = "Chronic kidney disease, CT angiography, Kidney transplantation, Nephrectomy",
author = "You, {Sung Hye} and Sung, {Deuk Jae} and Yang, {Kyung Sook} and Myung-Gyu Kim and Han, {Na Yeon} and Beomjin Park and Kim, {Min Ju}",
year = "2019",
month = "2",
day = "1",
doi = "10.2214/AJR.18.20135",
language = "English",
volume = "212",
pages = "W32--W40",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "2",

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TY - JOUR

T1 - Predicting the development of surgically induced chronic kidney disease after total nephrectomy using body surface area-adjusted renal cortical volume on CT angiography

AU - You, Sung Hye

AU - Sung, Deuk Jae

AU - Yang, Kyung Sook

AU - Kim, Myung-Gyu

AU - Han, Na Yeon

AU - Park, Beomjin

AU - Kim, Min Ju

PY - 2019/2/1

Y1 - 2019/2/1

N2 - OBJECTIVE. The purpose of this study was to predict the probability of surgically induced chronic kidney disease (CKD) developing in patients who underwent total nephrectomy by measuring the body surface area (BSA)-adjusted renal cortical volume (RCV) with preoperative CT angiography (CTA). MATERIALS AND METHODS. A total of 105 patients with a normal preoperative estimated glomerular filtration rate (eGFR) who underwent preoperative CTA and subsequent total nephrectomy for kidney donation (n = 67) or a renal tumor (n = 38) were included in this retrospective study. Patients were divided into group A (patients without surgically induced CKD; n = 61) and group B (patients with surgically induced CKD; n = 44) according to postoperative renal function. The preoperative and postoperative eGFR and other laboratory findings were collected, and the BSA-adjusted postnephrectomy RCV was measured using a semiautomated segmentation technique on CTA. Multiple logistic regression analysis was used to determine the formula for predicting the probability of development of surgically induced CKD; external validation was conducted using the validation dataset (n = 28). RESULTS. The estimated probability of surgically induced CKD developing can be calculated using the following formula: logit (probability of surgically induced CKD developing) = [1.431 × I (reason for operation was renal tumor)] + (-0.097 × preoperative eGFR) + (-0.033 × BSA-adjusted postnephrectomy RCV) + 10.937, where I denotes an indicator function (I = 1, reason for operation was renal tumor; I = 0, reason for operation was kidney donation). The optimal cutoff value derived from 10,000 bootstrapped samples was 0.444 (95% CI, 0.298-0.681). The formula was determined to be a good tool for prediction of surgically induced CKD on external validation (AUC value, 0.894). CONCLUSION. The probability of CKD developing in patients who undergo total nephrectomy may be predicted using a BSA-adjusted postnephrectomy RCV volume measured on preoperative CTA.

AB - OBJECTIVE. The purpose of this study was to predict the probability of surgically induced chronic kidney disease (CKD) developing in patients who underwent total nephrectomy by measuring the body surface area (BSA)-adjusted renal cortical volume (RCV) with preoperative CT angiography (CTA). MATERIALS AND METHODS. A total of 105 patients with a normal preoperative estimated glomerular filtration rate (eGFR) who underwent preoperative CTA and subsequent total nephrectomy for kidney donation (n = 67) or a renal tumor (n = 38) were included in this retrospective study. Patients were divided into group A (patients without surgically induced CKD; n = 61) and group B (patients with surgically induced CKD; n = 44) according to postoperative renal function. The preoperative and postoperative eGFR and other laboratory findings were collected, and the BSA-adjusted postnephrectomy RCV was measured using a semiautomated segmentation technique on CTA. Multiple logistic regression analysis was used to determine the formula for predicting the probability of development of surgically induced CKD; external validation was conducted using the validation dataset (n = 28). RESULTS. The estimated probability of surgically induced CKD developing can be calculated using the following formula: logit (probability of surgically induced CKD developing) = [1.431 × I (reason for operation was renal tumor)] + (-0.097 × preoperative eGFR) + (-0.033 × BSA-adjusted postnephrectomy RCV) + 10.937, where I denotes an indicator function (I = 1, reason for operation was renal tumor; I = 0, reason for operation was kidney donation). The optimal cutoff value derived from 10,000 bootstrapped samples was 0.444 (95% CI, 0.298-0.681). The formula was determined to be a good tool for prediction of surgically induced CKD on external validation (AUC value, 0.894). CONCLUSION. The probability of CKD developing in patients who undergo total nephrectomy may be predicted using a BSA-adjusted postnephrectomy RCV volume measured on preoperative CTA.

KW - Chronic kidney disease

KW - CT angiography

KW - Kidney transplantation

KW - Nephrectomy

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