Estimated functional renal parenchymal volume predicts the split renal function following renal surgery

Area of Science:

• Nephrology
• Radiology
• Surgical Oncology

Background:

• Functional renal volume (FRV) changes significantly impact renal function post-nephrectomy (Nx) or nephron-sparing surgery (NSS).
• Accurate prediction of postoperative renal function is crucial for patient management.

Purpose of the Study:

• To prospectively evaluate the predictive accuracy of postoperative renal function after Nx and NSS.
• To assess the reproducibility of a novel 3-D image reconstruction system for measuring FRV.

Main Methods:

• 98 Nx and 41 NSS patients were enrolled. FRV was measured preoperatively and at 1 month and 1 year postoperatively.
• Postoperative estimated glomerular filtration rate (eGFR) was predicted using preoperative eGFR and the ratio of postoperative/preoperative FRV.
• The 3-D system's accuracy and reproducibility were tested using CT and MRI scans by five examiners.

Main Results:

• A significant correlation was observed between predicted and actual FRV and renal function at 1 month and 1 year post-surgery in both Nx and NSS groups.
• The 3-D system demonstrated accuracy and reproducibility with both CT and MRI imaging modalities.

Conclusions:

• Postoperative functional renal volume and renal function can be reliably predicted preoperatively.
• A 3-D image reconstruction system, combined with routine imaging and serum creatinine levels, enables accurate preoperative prediction.