RÉSUMÉ
BACKGROUND: The aim of this study was to use the volume of the graft as an adjunct tool for better decision making. METHODS: Kidney transplanted patients with acute azotemia and documented volume and finally a biopsy were enrolled in this study|. Graft volumes between rejected patients (antibody-mediated rejection {AMR} and cell - mediated rejection {CMR}) and |non rejected but azotemic patients were compared. RESULTS: A total of 76 patients were enrolled in this study |(45 case and 31 control|). 53.3% of the case group were| (AMR)| and 46.7% belonged to |(CMR). There was no difference between kidney volume according to age or sex. But the case group had a significantly bigger volume than controls (253.09 cm3 and 186.45 cm3; p< 0.001). In addition, there was a significant difference between the volumes of AMR kidneys with CMR and controls |(286.24+66.70|, 224.08+76.79 and 186.95+39.92; P=0.003 and p<0.001, respectively), but not between CMR and controls |(P=0.067). A cutoff point of 200 cm3 was determined as rejection with sensitivity and specificity of 70% and a cutoff point of 250 cm3 could be used as AMR cut off with sensitivity of 76% and specificity of 70%. CONCLUSION: There was a significant difference in volume between rejection and control group and between AMR and CMR. So, kidney volume determination is an easy and valuable tool to help the clinician to have a more rapid and better decision making.