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Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat
Published on: July 26, 2015
Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy
Yoshimi Iwasaki1, Tokihiko Sawada, Shozo Mori
1Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan.
World Journal of Gastroenterology
|May 14, 2009
Summary
Estimated glomerular filtration rate (eGFR) equations, specifically eGFR5 and eGFR3, are superior to creatinine clearance (Ccr) for preoperative renal function assessment in hepatectomy patients. These eGFR calculations better predict postoperative serum creatinine levels.
Area of Science:
- Nephrology
- Hepatobiliary Surgery
- Clinical Chemistry
Background:
- Accurate preoperative assessment of renal function is crucial for patients undergoing major liver surgery.
- Creatinine clearance (Ccr) and estimated glomerular filtration rate (eGFR) are common methods for evaluating kidney function.
- The predictive value of Ccr versus eGFR for postoperative outcomes in hepatectomy patients requires clarification.
Purpose of the Study:
- To compare the efficacy of creatinine clearance (Ccr) and two estimated glomerular filtration rate (eGFR) equations (eGFR3 and eGFR5) as preoperative renal function tests in patients scheduled for hepatectomy.
- To determine which renal function test best predicts postoperative changes in serum creatinine levels.
Main Methods:
- A retrospective analysis of 197 patients undergoing hepatectomy was conducted.
- Preoperative Ccr, eGFR3, and eGFR5 were calculated.
- Abnormal renal function was defined as Ccr < 50 mL/min or eGFR < 60 mL/min/1.73 m(2).
- Maximum postoperative serum creatinine levels and the rate of increase were compared between groups with normal and abnormal renal function tests.
Main Results:
- Abnormal renal function was detected in 18.8% by Ccr, 15.7% by eGFR3, and 20.3% by eGFR5.
- While the postoperative serum creatinine rate did not differ significantly across groups, the postoperative serum creatinine level was significantly higher in patients with abnormal eGFR3 and eGFR5 compared to those with normal values (P < 0.0001).
- A trend towards higher postoperative serum creatinine levels was observed in patients with abnormal Ccr.
Conclusions:
- Both eGFR5 and the simpler eGFR3 equations are more effective than Ccr for preoperative renal function assessment in hepatectomy patients.
- eGFR provides a more sensitive prediction of postoperative renal function compared to Ccr in this surgical cohort.
- Routine use of eGFR equations is recommended for preoperative renal evaluation prior to hepatectomy.
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