Assessing renal function after partial nephrectomy using renal nuclear scintigraphy and estimated glomerular filtration rate. 2012

Alexander Sankin, and John P Sfakianos, and Jeffrey Schiff, and Daniel Sjoberg, and Jonathan A Coleman
Department of Urology, SUNY Downstate Medical Center, Brooklyn, NY, USA. alexsankin@gmail.com

OBJECTIVE To create a model intended to more accurately characterize renal function alteration after partial nephrectomy using a combination of renal scintigraphy and estimated glomerular filtration rate (eGFR). METHODS Thirty-two partial nephrectomy patients from a single center with preoperative and postoperative renal scans were reviewed. Renal scan data were used to calculate proportional eGFR in the involved kidney as a product of the percentage function of the operated kidney and total eGFR. Linear regression models were created to describe endpoints (postoperative eGFR, involved kidney percent function, proportional eGFR) as functions of clinical variables associated with kidney damage. RESULTS For the ipsilateral kidney, mean preoperative percent function and eGFR were 50% (SD, 4.8) and 31 mL/min/m(2) (SD, 3.4), respectively; postoperative percent function and involved kidney eGFR were 44% (SD, 9.0) and 27 mL/min/m(2) (SD, 9.0), respectively. Decreased postoperative proportional eGFR was significantly associated with increased clamp time and tumor size in univariate linear regression models. Clamp time was associated with total eGFR, where tumor size was not. Additionally, clamp time and tumor size explain more of the variation in proportional eGFR (R(2) = 0.39 and R(2) = 0.17, respectively), compared to percent effort and total eGFR. CONCLUSIONS Proportional eGFR has a stronger association with putative factors of renal dysfunction after partial nephrectomy, including clamp time and tumor size, compared to total eGFR, indicating it may be a more sensitive marker of renal function after partial nephrectomy.

UI MeSH Term Description Entries
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D007677 Kidney Function Tests Laboratory tests used to evaluate how well the kidneys are working through examination of blood and urine. Function Test, Kidney,Function Tests, Kidney,Kidney Function Test,Test, Kidney Function,Tests, Kidney Function
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009392 Nephrectomy Excision of kidney. Heminephrectomy,Heminephrectomies,Nephrectomies
D011877 Radionuclide Imaging The production of an image obtained by cameras that detect the radioactive emissions of an injected radionuclide as it has distributed differentially throughout tissues in the body. The image obtained from a moving detector is called a scan, while the image obtained from a stationary camera device is called a scintiphotograph. Gamma Camera Imaging,Radioisotope Scanning,Scanning, Radioisotope,Scintigraphy,Scintiphotography,Imaging, Gamma Camera,Imaging, Radionuclide
D005260 Female Females
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective

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