|Title:||MRI evaluation of the adaptive response of the contralateral kidney following nephrectomy in patients with renal cell carcinoma||Authors:||Su M.-Y.M.
|Issue Date:||2015||Publisher:||John Wiley and Sons Inc.||Journal Volume:||41||Journal Issue:||3||Start page/Pages:||822-828||Source:||Journal of Magnetic Resonance Imaging||Abstract:||
Purpose: To study the adaptive responses of the contralateral kidney and its association with renal outcome in patients with renal cell carcinoma (RCC) following radical nephrectomy (RN). Materials and Methods: Eleven patients with RCC scheduled for RN and 15 control patients scheduled for adrenalectomy (Control) were prospectively recruited. All subjects underwent 4 MRI studies: 1 before surgery and 3 at 1 week, 1 month and 3 months after surgery, respectively. T2-weighted imaging and dynamic contrast-enhanced imaging were performed to estimate the renal volume and renal blood flow (RBF) of the contralateral kidney, respectively. The patients' serum creatinine levels were examined to determine the estimated glomerular filtration rate (e-GFR). The changes in renal volume at 3 months and both RBF and e-GFR during the serial followup were compared and associations between both of them were measured in both groups. Results: In the RN group, RBF increased at 1 week (2.78 ± 0.93 mL/min/g, P=0.002) and 1 month (2.65 ± 0.85 mL/min/g, P=0.002), compared with presurgical values (1.94 ± 0.61 mL/min/g), and it returned to presurgical levels at 3 months (2.11 ± 0.73 mL/min/g, P=0.432). In contrast, e-GFR decreased at 1 week (56.4 ± 20.3 mL/min/1.73 m2, P=0.049) and 1 month (52.4 ± 18.8 mL/min/1.73 m2, P=0.027), compared with presurgical values (66.3 ± 18.3 mL/min/1.73 m2), and it returned to presurgical levels at 3 months (73.3 ± 29.5 mL/min/1.73 m2, P=0.496).The renal volume increased at 3 months compared with baseline (198 ± 87 versus 329 ± 175 mL, P < 0.001). The change in renal volume was correlated with the change in RBF at 1 week (r=0.609, P=0.047). Conclusion: In patients with RCC following RN, an early increase in RBF of the contralateral kidney is associated with late renal hypertrophy which might normalize glomerular hyperfiltration and restore renal function. ? 2014 Wiley Periodicals, Inc.
|ISSN:||1053-1807||DOI:||10.1002/jmri.24596||metadata.dc.subject.other:||creatinine; adrenalectomy; adult; aged; Article; cancer surgery; clinical article; contrast enhancement; controlled study; creatinine blood level; disease course; female; follow up; glomerulus filtration rate; human; kidney blood flow; kidney carcinoma; kidney hypertrophy; male; middle aged; nephrectomy; nuclear magnetic resonance imaging; priority journal; prospective study; ultrafiltration; Carcinoma, Renal Cell; kidney; kidney circulation; Kidney Neoplasms; physiology; postoperative period; Aged; Carcinoma, Renal Cell; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Kidney; Kidney Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Nephrectomy; Postoperative Period; Prospective Studies; Renal Circulation
|Appears in Collections:||醫學系|
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