Renal parenchymal volume analysis: Clinical and research applications

Abstract Background and Objectives In most patients, the renal parenchymal volumes in each kidney directly correlate with function and can be used as a proxy to determine split renal function (SRF). This simple principle forms the basis for parenchymal volume analysis (PVA) with semiautomated softwa...

Full description

Saved in:
Bibliographic Details
Main Authors: Carlos Munoz‐Lopez, Kieran Lewis, Nityam Rathi, Eran Maina, Akira Kazama, Anne Wong, Angelica Bartholomew, Worapat Attawettayanon, Yunlin Ye, Zhiling Zhang, Wen Dong, Rebecca A. Campbell, Nicholas Heller, Erick Remer, Christopher Weight, Steven C. Campbell
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:BJUI Compass
Subjects:
Online Access:https://doi.org/10.1002/bco2.70013
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849339745136541696
author Carlos Munoz‐Lopez
Kieran Lewis
Nityam Rathi
Eran Maina
Akira Kazama
Anne Wong
Angelica Bartholomew
Worapat Attawettayanon
Yunlin Ye
Zhiling Zhang
Wen Dong
Rebecca A. Campbell
Nicholas Heller
Erick Remer
Christopher Weight
Steven C. Campbell
author_facet Carlos Munoz‐Lopez
Kieran Lewis
Nityam Rathi
Eran Maina
Akira Kazama
Anne Wong
Angelica Bartholomew
Worapat Attawettayanon
Yunlin Ye
Zhiling Zhang
Wen Dong
Rebecca A. Campbell
Nicholas Heller
Erick Remer
Christopher Weight
Steven C. Campbell
author_sort Carlos Munoz‐Lopez
collection DOAJ
description Abstract Background and Objectives In most patients, the renal parenchymal volumes in each kidney directly correlate with function and can be used as a proxy to determine split renal function (SRF). This simple principle forms the basis for parenchymal volume analysis (PVA) with semiautomated software, which can be leveraged to predict SRF and new‐baseline glomerular filtration rate (NBGFR) following nephrectomy. PVA was originally used to evaluate renal transplantation donors and has replaced nuclear renal scans (NRS) in this domain. PVA has subsequently been explored for the management of patients with kidney cancer for whom difficult decisions about radical versus partial nephrectomy can be influenced by accurate prediction of NBGFR. Our objective is to present a comprehensive review of the applications of PVA in urology including their clinical and research implications. Methods Key articles utilizing renal PVA to improve clinical care and facilitate urologic research were reviewed with special emphasis on take‐home points of clinical relevance and their contributions to progress in the field. Results There have been considerable advances in renal PVA over the past 15 years, which is now established as a reference standard for the prediction of functional outcomes after renal surgery. PVA provides improved accuracy when compared to NRS‐based estimates or non‐SRF‐based algorithms. PVA can be performed in minutes using routine preoperative cross‐sectional imaging and can be readily applied at the point of care. Additionally, PVA has important research applications, enabling the precise study of the determinants of functional recovery after partial nephrectomy, which can affect surgical approaches to this procedure. Conclusions Despite the wide availability of PVA, primarily for use in renal transplantation, it has not been widely implemented for other urologic purposes at most centres. Our hope is that this narrative review will increase PVA utilization in urology and facilitate further progress in the field.
format Article
id doaj-art-07a9d3eb84dc470497097692eba92e2e
institution Kabale University
issn 2688-4526
language English
publishDate 2025-03-01
publisher Wiley
record_format Article
series BJUI Compass
spelling doaj-art-07a9d3eb84dc470497097692eba92e2e2025-08-20T03:44:04ZengWileyBJUI Compass2688-45262025-03-0163n/an/a10.1002/bco2.70013Renal parenchymal volume analysis: Clinical and research applicationsCarlos Munoz‐Lopez0Kieran Lewis1Nityam Rathi2Eran Maina3Akira Kazama4Anne Wong5Angelica Bartholomew6Worapat Attawettayanon7Yunlin Ye8Zhiling Zhang9Wen Dong10Rebecca A. Campbell11Nicholas Heller12Erick Remer13Christopher Weight14Steven C. Campbell15Glickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USADivision of Urology, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital Prince of Songkla University Songkhla ThailandDepartment of Urology, Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaDepartment of Urology, Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaDepartment of Urology, Sun Yat‐sen University Cancer Center Guangzhou P. R. ChinaGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAGlickman Urological and Kidney Institute, Cleveland Clinic Cleveland OH USAAbstract Background and Objectives In most patients, the renal parenchymal volumes in each kidney directly correlate with function and can be used as a proxy to determine split renal function (SRF). This simple principle forms the basis for parenchymal volume analysis (PVA) with semiautomated software, which can be leveraged to predict SRF and new‐baseline glomerular filtration rate (NBGFR) following nephrectomy. PVA was originally used to evaluate renal transplantation donors and has replaced nuclear renal scans (NRS) in this domain. PVA has subsequently been explored for the management of patients with kidney cancer for whom difficult decisions about radical versus partial nephrectomy can be influenced by accurate prediction of NBGFR. Our objective is to present a comprehensive review of the applications of PVA in urology including their clinical and research implications. Methods Key articles utilizing renal PVA to improve clinical care and facilitate urologic research were reviewed with special emphasis on take‐home points of clinical relevance and their contributions to progress in the field. Results There have been considerable advances in renal PVA over the past 15 years, which is now established as a reference standard for the prediction of functional outcomes after renal surgery. PVA provides improved accuracy when compared to NRS‐based estimates or non‐SRF‐based algorithms. PVA can be performed in minutes using routine preoperative cross‐sectional imaging and can be readily applied at the point of care. Additionally, PVA has important research applications, enabling the precise study of the determinants of functional recovery after partial nephrectomy, which can affect surgical approaches to this procedure. Conclusions Despite the wide availability of PVA, primarily for use in renal transplantation, it has not been widely implemented for other urologic purposes at most centres. Our hope is that this narrative review will increase PVA utilization in urology and facilitate further progress in the field.https://doi.org/10.1002/bco2.70013functional recoverykidney cancernew baseline glomerular filtration rateparenchymal volume analysispartial nephrectomyradical nephrectomy
spellingShingle Carlos Munoz‐Lopez
Kieran Lewis
Nityam Rathi
Eran Maina
Akira Kazama
Anne Wong
Angelica Bartholomew
Worapat Attawettayanon
Yunlin Ye
Zhiling Zhang
Wen Dong
Rebecca A. Campbell
Nicholas Heller
Erick Remer
Christopher Weight
Steven C. Campbell
Renal parenchymal volume analysis: Clinical and research applications
BJUI Compass
functional recovery
kidney cancer
new baseline glomerular filtration rate
parenchymal volume analysis
partial nephrectomy
radical nephrectomy
title Renal parenchymal volume analysis: Clinical and research applications
title_full Renal parenchymal volume analysis: Clinical and research applications
title_fullStr Renal parenchymal volume analysis: Clinical and research applications
title_full_unstemmed Renal parenchymal volume analysis: Clinical and research applications
title_short Renal parenchymal volume analysis: Clinical and research applications
title_sort renal parenchymal volume analysis clinical and research applications
topic functional recovery
kidney cancer
new baseline glomerular filtration rate
parenchymal volume analysis
partial nephrectomy
radical nephrectomy
url https://doi.org/10.1002/bco2.70013
work_keys_str_mv AT carlosmunozlopez renalparenchymalvolumeanalysisclinicalandresearchapplications
AT kieranlewis renalparenchymalvolumeanalysisclinicalandresearchapplications
AT nityamrathi renalparenchymalvolumeanalysisclinicalandresearchapplications
AT eranmaina renalparenchymalvolumeanalysisclinicalandresearchapplications
AT akirakazama renalparenchymalvolumeanalysisclinicalandresearchapplications
AT annewong renalparenchymalvolumeanalysisclinicalandresearchapplications
AT angelicabartholomew renalparenchymalvolumeanalysisclinicalandresearchapplications
AT worapatattawettayanon renalparenchymalvolumeanalysisclinicalandresearchapplications
AT yunlinye renalparenchymalvolumeanalysisclinicalandresearchapplications
AT zhilingzhang renalparenchymalvolumeanalysisclinicalandresearchapplications
AT wendong renalparenchymalvolumeanalysisclinicalandresearchapplications
AT rebeccaacampbell renalparenchymalvolumeanalysisclinicalandresearchapplications
AT nicholasheller renalparenchymalvolumeanalysisclinicalandresearchapplications
AT erickremer renalparenchymalvolumeanalysisclinicalandresearchapplications
AT christopherweight renalparenchymalvolumeanalysisclinicalandresearchapplications
AT stevenccampbell renalparenchymalvolumeanalysisclinicalandresearchapplications