Can the estimated glomerular filtration rate be used to evaluate preoperative renal function in patients with renal carcinoma

2020 
248 Objectives: Estimated glomerular filtration rate (eGFR) has been widely used in the detection of renal function in patients with chronic kidney disease. Reported literatures indicates that there are significant correlation between eGFR and Gates-GFR(gGFR) in patients with renal carcinoma, and preoperative renal function can be evaluated by eGFR. Base on the conclusion, we aim to compare three GFR measurement methods to explore the accuracy of eGFR to evaluate preoperative renal function in patients with renal carcinoma. Methods: A total of 281 patients with unilateral non-metastatic renal tumor were recruited. Average patients age was (58.39 ± 10.21) years. Based on the patient9s age and preoperative serum creatinine value, the patients were divided into four groups: group 1(male, serum creatinine value was normal), 140 cases, average serum creatinine value was 78.2 ± 85.8μmol/L; group 2(male, serum creatinine value was abnormal), 31 cases, average serum creatinine value was 68.35 ± 23.25μmol/L; group 3(female, serum creatinine value was normal), 80 cases, average serum creatinine value was 60.27 ± 6.4μmol/L; group 4(female, serum creatinine value was abnormal) , 30 cases, average serum creatinine value was 48.13 ± 12.12 μmol/L. Radionuclide 99mTc-DTPA were performed preoperatively into every patient, and gGFR and tGFR were obtained followed. The eGFR of tumor patients was calculated by CKD-EPIscr and simplified MDRD. Spearman correlation analysis were used to analyze the corrlations among three GFR measurement methods. tGFR as the reference standard, compared the difference between eGFR and tGFR with t-test, where the paired t-test results indicate the deviations of the eGFR and tGFR. The intraclass correlation efficient(ICC) was used to evaluate the consistency of eGFR and tGFR. Results: The results obtained using spearman correlation analysis shows that eGFR was positively correlated with gGFR and tGFR in the four groups, but the relativity between each group was not significantly as reported literatures, gGFR and tGFR are moderately correlated(Table1). The difference between each eGFR and tGFR is statistically significant (P <0.001). The intraclass correlation efficient shows that the consistency between each eGFR and tGFR is not significant(Table2). Conclusions: In this study population, the correlation and consistency of eGFR with tGFR and gGFR are lower than Reported literatures. Shows that eGFR has limited evaluation value for patients with unilateral renal tumor, even results in large deviations between Measured values and real values, which affects the choice of surgical approach. Study also shows that combine gGFR and tGFR can improving the accuracy for total and single renal function.
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