Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 14, 2009; 15(18): 2252-2257
Published online May 14, 2009. doi: 10.3748/wjg.15.2252
Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy
Yoshimi Iwasaki, Tokihiko Sawada, Shozo Mori, Yukihiro Iso, Masato Katoh, Kyu Rokkaku, Junji Kita, Mitsugi Shimoda, Keiichi Kubota
Yoshimi Iwasaki, Tokihiko Sawada, Shozo Mori, Yukihiro Iso, Masato Katoh, Kyu Rokkaku, Junji Kita, Mitsugi Shimoda, Keiichi Kubota, Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan
Author contributions: Iwasaki Y and Sawada T performed the research, analyzed the data and wrote the paper; Sawada T designed the research; Mori S, Iso Y, Katoh M, Rokkaku K, Kita J, and Shimoda M performed the operation and collected the data; Kubota K supervised the research.
Correspondence to: Tokihiko Sawada, MD, PhD, Department of Gastroenterological Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, 321-0293, Japan. tsawada@dokkyomed.ac.jp
Telephone: +81-282-861111
Fax: +81-282-866317
Received: February 5, 2009
Revised: April 3, 2009
Accepted: April 10, 2009
Published online: May 14, 2009
Abstract

AIM: To compare creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) in preoperative renal function tests in patients undergoing hepatectomy.

METHODS: The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied, and preoperative Ccr, a three-variable equation for eGFR (eGFR3) and a five-variable equation for eGFR (eGFR5) were calculated. Abnormal values were defined as Ccr < 50 mL/min, eGFR3 and eGFR5 < 60 mL/min per 1.73 m2. The maximum increases in the postoperative serum creatinine (post Cr) level and postoperative rate of increase in the serum Cr level (post Cr rate) were compared.

RESULTS: There were 37 patients (18.8%) with abnormal Ccr, 31 (15.7%) with abnormal eGFR3, and 40 (20.3%) with abnormal eGFR5. Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr, eGFR3 and eGFR5 values, the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients (P < 0.0001). Post Cr level tended to be higher in patients with Ccr abnormality (P = 0.0936 and P = 0.0875, respectively).

CONCLUSION: eGFR5 and the simpler eGFR3, rather than Ccr, are recommended as a preoperative renal function test in patients undergoing hepatectomy.

Keywords: Estimated glomerular filtration rate, Creatinine clearance test, Hepatectomy, Renal function test