title: Computed tomography based renal parenchyma volume measurements prior to renal tumor surgery are predictive of postoperative renal function.
abstract: BACKGROUND
  To determine whether preoperative computed tomography (CT) based renal parenchymal volume (RPV) measurements would be predictive of postoperative chronic kidney disease (CKD).
  
  
  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 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 risks of developing CKD were 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.
authors.affiliation: Department of Urology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Kunzel
authors.forename: William
authors.initials: W
authors.lastname: Small
authors.forename: Michael
authors.initials: M
authors.lastname: Goodman
authors.forename: John
authors.initials: J
authors.lastname: Pattaras
authors.forename: Viraj
authors.initials: V
authors.lastname: Master
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ogan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009929:Organ Size; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography
chemical_list: D003404:Creatinine