en Nephrology Nephrology Original Article Original Article <span style="font-size:14px;"><span style="font-family:times new roman;"><span style="color:#0000FF;"><strong><em>Background</em></strong><em>:</em> </span>The aim of this study was to use the volume of the graft as an adjunct tool for better decision making.<br> <span style="color:#0000FF;"><strong><em>Methods</em></strong><em>:</em> </span>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.<br> <span style="color:#0000FF;"><strong><em>Results</em></strong><em>:</em></span> 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<u>+</u>66.70‌, 224.08<u>+</u>76.79 and 186.95<u>+</u>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%.<br> <span style="color:#0000FF;"><strong><em>Conclusion</em></strong><em>:</em></span> 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.</span></span> Keywords : Kidney transplantation, kidney volume, AMR, CMR, Ultrasonography 11 15 http://caspjim.com/browse.php?a_code=A-10-158-3&slc_lang=en&sid=1 Mohammad Yazdani bcrdc90@yahoo.com 100319475328460014901 100319475328460014901 No Student Research Committee, Babol University of Medical Science, Babol, Iran Nasser Ghaemian nghaemiyan@yahoo.com 100319475328460014902 100319475328460014902 No Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Soraya Khafri khafri@yahoo.com 100319475328460014903 100319475328460014903 No Infertility and Health Reproductive Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Farshid Oliaei ol_1964@yahoo.com 100319475328460014904 100319475328460014904 Yes Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran