Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis

Abstract Objectives To investigate the relationship between low kidney volume and subsequent estimated glomerular filtration rate (eGFR) decline in eGFR category G2 (60–89 mL/min/1.73 m2) population. Methods In this retrospective study, we evaluated 5531 individuals with eGFR category G2 who underwe...

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Main Authors: Tomohiro Kikuchi, Shouhei Hanaoka, Takahiro Nakao, Yukihiro Nomura, Harushi Mori, Takeharu Yoshikawa
Format: Article
Language:English
Published: SpringerOpen 2024-04-01
Series:Insights into Imaging
Subjects:
Online Access:https://doi.org/10.1186/s13244-024-01671-2
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author Tomohiro Kikuchi
Shouhei Hanaoka
Takahiro Nakao
Yukihiro Nomura
Harushi Mori
Takeharu Yoshikawa
author_facet Tomohiro Kikuchi
Shouhei Hanaoka
Takahiro Nakao
Yukihiro Nomura
Harushi Mori
Takeharu Yoshikawa
author_sort Tomohiro Kikuchi
collection DOAJ
description Abstract Objectives To investigate the relationship between low kidney volume and subsequent estimated glomerular filtration rate (eGFR) decline in eGFR category G2 (60–89 mL/min/1.73 m2) population. Methods In this retrospective study, we evaluated 5531 individuals with eGFR category G2 who underwent medical checkups at our institution between November 2006 and October 2017. Exclusion criteria were absent for follow-up visit, missing data, prior renal surgery, current renal disease under treatment, large renal masses, and horseshoe kidney. We developed a 3D U-net-based automated system for renal volumetry on CT images. Participants were grouped by sex-specific kidney volume deviations set at mean minus one standard deviation. After 1:1 propensity score matching, we obtained 397 pairs of individuals in the low kidney volume (LKV) and control groups. The primary endpoint was progression of eGFR categories within 5 years, assessed using Cox regression analysis. Results This study included 3220 individuals (mean age, 60.0 ± 9.7 years; men, n = 2209). The kidney volume was 404.6 ± 67.1 and 376.8 ± 68.0 cm3 in men and women, respectively. The low kidney volume (LKV) cutoff was 337.5 and 308.8 cm3 for men and women, respectively. LKV was a significant risk factor for the endpoint with an adjusted hazard ratio of 1.64 (95% confidence interval: 1.09–2.45; p = 0.02). Conclusion Low kidney volume may adversely affect subsequent eGFR maintenance; hence, the use of imaging metrics may help predict eGFR decline. Critical relevance statement Low kidney volume is a significant predictor of reduced kidney function over time; thus, kidney volume measurements could aid in early identification of individuals at risk for declining kidney health. Key points • This study explores how kidney volume affects subsequent kidney function maintenance. • Low kidney volume was associated with estimated glomerular filtration rate decreases. • Low kidney volume is a prognostic indicator of estimated glomerular filtration rate decline. Graphical Abstract
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spelling doaj.art-8bbdfcebb2ae494fbce3ac907f680dc02024-04-07T11:20:56ZengSpringerOpenInsights into Imaging1869-41012024-04-011511810.1186/s13244-024-01671-2Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysisTomohiro Kikuchi0Shouhei Hanaoka1Takahiro Nakao2Yukihiro Nomura3Harushi Mori4Takeharu Yoshikawa5Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo HospitalDepartment of Radiology, University of Tokyo HospitalDepartment of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo HospitalDepartment of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo HospitalDepartment of Radiology, Jichi Medical University School of MedicineDepartment of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo HospitalAbstract Objectives To investigate the relationship between low kidney volume and subsequent estimated glomerular filtration rate (eGFR) decline in eGFR category G2 (60–89 mL/min/1.73 m2) population. Methods In this retrospective study, we evaluated 5531 individuals with eGFR category G2 who underwent medical checkups at our institution between November 2006 and October 2017. Exclusion criteria were absent for follow-up visit, missing data, prior renal surgery, current renal disease under treatment, large renal masses, and horseshoe kidney. We developed a 3D U-net-based automated system for renal volumetry on CT images. Participants were grouped by sex-specific kidney volume deviations set at mean minus one standard deviation. After 1:1 propensity score matching, we obtained 397 pairs of individuals in the low kidney volume (LKV) and control groups. The primary endpoint was progression of eGFR categories within 5 years, assessed using Cox regression analysis. Results This study included 3220 individuals (mean age, 60.0 ± 9.7 years; men, n = 2209). The kidney volume was 404.6 ± 67.1 and 376.8 ± 68.0 cm3 in men and women, respectively. The low kidney volume (LKV) cutoff was 337.5 and 308.8 cm3 for men and women, respectively. LKV was a significant risk factor for the endpoint with an adjusted hazard ratio of 1.64 (95% confidence interval: 1.09–2.45; p = 0.02). Conclusion Low kidney volume may adversely affect subsequent eGFR maintenance; hence, the use of imaging metrics may help predict eGFR decline. Critical relevance statement Low kidney volume is a significant predictor of reduced kidney function over time; thus, kidney volume measurements could aid in early identification of individuals at risk for declining kidney health. Key points • This study explores how kidney volume affects subsequent kidney function maintenance. • Low kidney volume was associated with estimated glomerular filtration rate decreases. • Low kidney volume is a prognostic indicator of estimated glomerular filtration rate decline. Graphical Abstracthttps://doi.org/10.1186/s13244-024-01671-2Chronic renal insufficiencyGlomerular filtration rateKidneyX-ray computed tomography
spellingShingle Tomohiro Kikuchi
Shouhei Hanaoka
Takahiro Nakao
Yukihiro Nomura
Harushi Mori
Takeharu Yoshikawa
Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis
Insights into Imaging
Chronic renal insufficiency
Glomerular filtration rate
Kidney
X-ray computed tomography
title Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis
title_full Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis
title_fullStr Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis
title_full_unstemmed Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis
title_short Impact of CT-determined low kidney volume on renal function decline: a propensity score-matched analysis
title_sort impact of ct determined low kidney volume on renal function decline a propensity score matched analysis
topic Chronic renal insufficiency
Glomerular filtration rate
Kidney
X-ray computed tomography
url https://doi.org/10.1186/s13244-024-01671-2
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