A road map for patients with imminent end-stage renal disease.

Chronic kidney disease (CKD) represents a relevant medical and financial burden. More than 5% of the population suffers from CKD. There should be an accurately timed evaluation of best renal replacement therapy in all patients with CKD. Kidney transplantation is the treatment of choice for patients with end-stage renal disease. Living donated kidney transplantation offers the best results and should be evaluated in every patient suitable for transplantation. Haemodialysis and peritoneal dialysis are equally effective treatment options in patients not suitable for transplantation and should be individually evaluated. Conservative treatment, avoiding a dialysis treatment, can also be an option. Close cooperation of the general practitioner with a nephrologist improves patient management and helps to lower costs.

Comparison of CT angiography with MR angiography in the preoperative assessment of living kidney donors.

BACKGROUND: The aim of the study was to prospectively compare the diagnostic performance of CT angiography (CTA) with MR angiography (MRA) in the preoperative assessment of living renal donors. METHODS: Forty-eight potential living renal donors (mean 51 years, 29-67 years) underwent multislice CTA and gadolinium-enhanced MRA. Six potential donors were excluded. Forty-two donors underwent minimal invasive retroperitoneoscopic nephrectomy (left 36, right 6) and their datasets available for analysis independently performed by two blinded radiologists. The surgical status served as gold standard. RESULTS: In 42 donors (84 kidneys), CTA identified 63 kidneys with 1 artery (MRI 61), 19 with 2 arteries (MRI 20), one with three arteries (MRI 2), and one with four arteries (MRI 1). Considering only the side with the surgical status available for verification, both CT and MRI correctly characterized 35 of 36 donors with a single renal artery and five of six with one supernumerary artery. Two false positives were two arteries suggested as supernumerary both in CT and MRI not confirmed during surgery. CTA and MRA both correctly identified three accessory renal veins in two donors. CONCLUSION: CTA and MRA had the same accuracy for characterization of renal vasculature in the preoperative assessment of living renal donors.