The impact of measuring split kidney function on post-donation kidney function: A retrospective cohort study.

Area of Science:

• Nephrology
• Radiology
• Transplant Surgery

Background:

• Split kidney function (SKF) assessment is crucial for living kidney donors.
• Computed tomography (CT) and renography are used for SKF determination.
• Correlation of these methods with post-donation kidney function requires clarification.

Purpose of the Study:

• To compare CT measurements and renography in assessing SKF.
• To evaluate the correlation of CT and renography-based SKF with post-donation kidney function.
• To analyze high-risk donor subgroups.

Main Methods:

• Retrospective cohort study of 248 living kidney donors.
• Pearson correlations assessed post-donation kidney function against renography and CT measurements.
• Analysis of high-risk groups: SKF difference >10% or post-donation eGFR <60 mL/min/1.73m².

Main Results:

• Post-donation kidney function showed poor correlation with both CT and renography (r < 0.4).
• CT and renography demonstrated agreement in SKF determination (Bland-Altman analysis).
• CT missed significant SKF differences (>10%) in 77% of relevant cases.

Conclusions:

• CT and renography do not reliably predict post-donation kidney function in living donors.
• Agreement between CT and renography for SKF does not translate to predictive value for future kidney function.
• Optimal methods for predicting remaining kidney function post-donation require further investigation.