Open Access

ARTICLE

Computed tomography based renal parenchyma volume measurements prior to renal tumor surgery are predictive of postoperative renal function

Brian Kunzel¹, William Small², Michael Goodman³, John Pattaras¹, Viraj Master¹, Kenneth Ogan¹

1 Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA
2 Department of Radiology, Emory University School of Medicine, Atlanta, Georgia, USA
3 Rollins School of Public Health, Emory University School of Medicine, Atlanta, Georgia, USA
Address correspondence to Dr. Kenneth Ogan, Department of Urology, Emory University School of Medicine, 1365 Clifton Road NE, Building B, Suite 1400, Atlanta, GA30322 USA

Canadian Journal of Urology 2013, 20(2), 6714-6720.

Abstract

Introduction: To determine whether preoperative computed tomography (CT)-based renal parenchymal volume (RPV) measurements would be predictive of postoperative chronic kidney disease (CKD).
Materials and methods: From 2005 to 2010, 189 patients with preoperative CT imaging performed at Emory University Hospital underwent renal tumor surgery. Preoperative and postoperative renal function was determined by estimating glomerular filtration rate (GFR) using standard Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations. Preoperative CT-measured RPV was calculated to determine the association of predicted preserved renal parenchyma with postoperative renal function and the development of CKD (GFR < 60 mL/min/1.73 m²).
Results: For the entire cohort, radical nephrectomy (RN), lower preoperative GFR, and volume of kidney without tumor were associated with the development of CKD (p < 0.05). If the non-tumor bearing kidney constituted ≥ 50% of the total bilateral preoperative RPV, then the risk of developing CKD was decreased. In patients treated with partial nephrectomy (PN) or ablation, total bilateral preoperative RPV measurements predicted postoperative renal function (CKD ≥ 3 versus CKD < 3) to a significant degree (p < 0.001).
Conclusions: Preoperative CT-based RPV measurements are independently associated with the development of CKD in patients undergoing renal tumor surgery. This provides urologists with another tool in the assessment of patients with renal tumors.

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