OBJECTIVE: A retrospective study was conducted to compare measured creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) as a preoperative renal function test in patients undergoing pancreatoduodenectomy. METHODS: The records of 139 patients undergoing pancreatoduodenectomy were enrolled, and preoperative Ccr, a 3-variable equation for eGFR (eGFR3) and a 5-variable equation for eGFR (eGFR5) were estimated. The maximum increases in the postoperative serum creatinine and urea nitrogen levels were compared between the groups with normal and abnormal levels relative to Ccr, eGFR3, and eGFR5. RESULTS: There were 30 patients with abnormal Ccr levels, 17 with abnormal eGFR3 levels, and 16 with abnormal eGFR5 levels. Postoperative serum creatinine and urea nitrogen levels were significantly higher in patients with eGFR3 and eGFR5 abnormal levels than in patients with eGFR3 and eGFR5 normal levels. Postoperative serum creatinine and urea nitrogen levels tended to be higher in patients with Ccr abnormal level. The sensitivity and specificity of eGFR3 and eGFR5 for postoperative renal dysfunction were better than those of Ccr, and multivariate analysis showed that eGFR5 was the only independent predictive factor for postoperative renal dysfunction. CONCLUSIONS: The eGFR5 and eGFR3, rather than the Ccr, are recommended as preoperative renal function test in patients undergoing pancreatoduodenectomy.
OBJECTIVE: A retrospective study was conducted to compare measured creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) as a preoperative renal function test in patients undergoing pancreatoduodenectomy. METHODS: The records of 139 patients undergoing pancreatoduodenectomy were enrolled, and preoperative Ccr, a 3-variable equation for eGFR (eGFR3) and a 5-variable equation for eGFR (eGFR5) were estimated. The maximum increases in the postoperative serum creatinine and ureanitrogen levels were compared between the groups with normal and abnormal levels relative to Ccr, eGFR3, and eGFR5. RESULTS: There were 30 patients with abnormal Ccr levels, 17 with abnormal eGFR3 levels, and 16 with abnormal eGFR5 levels. Postoperative serum creatinine and ureanitrogen levels were significantly higher in patients with eGFR3 and eGFR5 abnormal levels than in patients with eGFR3 and eGFR5 normal levels. Postoperative serum creatinine and ureanitrogen levels tended to be higher in patients with Ccr abnormal level. The sensitivity and specificity of eGFR3 and eGFR5 for postoperative renal dysfunction were better than those of Ccr, and multivariate analysis showed that eGFR5 was the only independent predictive factor for postoperative renal dysfunction. CONCLUSIONS: The eGFR5 and eGFR3, rather than the Ccr, are recommended as preoperative renal function test in patients undergoing pancreatoduodenectomy.
Authors: Malcolm H Squires; Vishes V Mehta; Sarah B Fisher; Neha L Lad; David A Kooby; Juan M Sarmiento; Kenneth Cardona; Maria C Russell; Charles A Staley; Shishir K Maithel Journal: J Am Coll Surg Date: 2013-11-07 Impact factor: 6.113