Purpose: Recent studies reported that the presence of metabolic syndrome is closely correlated with impaired kidney function after living donor nephrectomy. Since the measurement of body mass index cannot differentiate the amount of body adipose tissue from total body weight, body mass index is not a reliable parameter for determining metabolic syndrome. In the present study, we investigated the correlation between body adipose tissue and kidney function recovery following living donor nephrectomy.Materials and Methods: The patients who underwent living kidney donor nephrectomy consequently from July 2016 through December 2017 were enrolled in the study. We preoperatively measured the visceral (VAdT), retroperitoneal (RPAdT), and subcutaneous (SCAdT) adipose tissue volume by a computed tomography scan. Body mass index, adipose tissue measurements, and postoperative estimated glomerular filtration rate (eGFR) were evaluated.Results: The decrease between preoperative eGFR, and the first day, the first month and the sixth month eGFR after surgery were statistically significant (P = .001; P = .001; P = .001, respectively). The negative correlation between VAdT/SCAdT measurements and changes in eGFR at the first and the sixth postoperative month compared to preoperative eGFR were statistically significant (P = .049; P = .041, respectively). Additionally, RPAdT measurements and changes in eGFR at the first and the sixth postoperative month compared to preoperative eGFR (decreasing as RPAdT value increased) were statistically significant (P = .035; P = .026, respectively).Conclusion: According to a preoperative computed tomography scan, VAdT, RPAdT, and VAdT-to-SAdT ratiocan predict impaired kidney function recovery. Furthermore, RPAdT measurement is a new variable to predict the impaired kidney function after living donor nephrectomy.
Background: The Nutcracker phenomenon (NC-P) is the entrapment of the left kidney vein (LKV) between the superior mesenteric artery and the abdominal portion of the aorta. We aimed to evaluate the frequency of significant left renal vein compression in a healthy population. Materials and methods: The computed tomography angiography images of the 131 healty patients who underwent living kidney donor nephrectomy at our institution were enrolled in this retrospective, descriptive anatomic study. Results: Three (2.3%) cases had severe, 26 (19.8) had moderate stenosis. The mean aorto-mesenteric angle was more narrow in females (p < 0.05). The mean LKV diameter ratio and beak angle were shorter and more narrow in females (p < 0.05, p < 0.01; respectively). Thirteen cases (9.9%) showed three or four positive criteria for NC-P. As patients got younger and had BMI < 30 kg/m 2 , the rate of positive criteria determination was increased (p < 0.05, p < 0.01; respectively). Conclusions: The NC-P criteria were seen with a high frequency in healthy individuals. Female and younger individuals with less BMI showed a greater prevalence of positive criteria. Revision of the current standards for NC-P with a distinct classification between sex, age, and BMI is required to assess LKV compression better.
