Shingo Fujio1, Koji Takano2, Hiroshi Arimura3, Mika Habu4, Manoj Bohara4, Horofumi Hirano4, Ryosuke Hanaya4, Yoshihiko Nishio3, Chihaya Koriyama5, Yasuyuki Kinoshita6, Kazunori Arita4. 1. Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan ofuji@m2.kufm.kagoshima-u.ac.jp. 2. Department of EndocrinologyDiabetes and Metabolism, School of Medicine, Kitasato University, Sagamihara, Japan. 3. Department of DiabetesMetabolism and Endocrinology. 4. Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. 5. Department of Epidemiology and Preventive MedicineGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. 6. Department of NeurosurgeryGraduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
Abstract
OBJECTIVE: The glomerular filtration rate (GFR) is increased in patients with active acromegaly. The aim of this study is to elucidate whether renal function deteriorates in patients with acromegaly and whether this deterioration is reversible after surgical remission. DESIGN/ METHODS: A case-control study of 48 acromegalic patients who were surgically cured (cases) and 48 patients with nonfunctioning pituitary adenomas (NFomas, controls) was conducted. We performed clinical and biochemical examinations before surgery and 3months post-surgery. The GFR of each patient was estimated (estimated GFR, eGFR) using their serum creatinine, age, sex, and body surface area, and postoperative changes in the eGFR were assessed. RESULTS: The preoperative eGFR was significantly higher in patients with acromegaly than in those with NFoma (99.8 vs 75.1mL/min respectively, P<0.01). In acromegalic patients, surgical remission was accompanied by a significant decline in the eGFR (from 99.8 to 86.2mL/min, P<0.01). Conversely, in patients with NFoma, the postoperative eGFR did not change significantly (from 75.1 to 81.9mL/min, P=0.12). Among the acromegalic patients, the postoperative decreases in the eGFR were more prominent in patients with a preoperatively high or normal vs low eGFR. CONCLUSIONS: Our data demonstrated a significant post-surgical eGFR decrease in patients with acromegaly, but not in patients with NFomas. This change in the eGFR was reversible in acromegalic patients with a high/normal preoperative eGFR, but not in those with a low preoperative eGFR. This suggests that the reversible pathophysiological change in some patients is functional but not organic.
OBJECTIVE: The glomerular filtration rate (GFR) is increased in patients with active acromegaly. The aim of this study is to elucidate whether renal function deteriorates in patients with acromegaly and whether this deterioration is reversible after surgical remission. DESIGN/ METHODS: A case-control study of 48 acromegalicpatients who were surgically cured (cases) and 48 patients with nonfunctioning pituitary adenomas (NFomas, controls) was conducted. We performed clinical and biochemical examinations before surgery and 3months post-surgery. The GFR of each patient was estimated (estimated GFR, eGFR) using their serum creatinine, age, sex, and body surface area, and postoperative changes in the eGFR were assessed. RESULTS: The preoperative eGFR was significantly higher in patients with acromegaly than in those with NFoma (99.8 vs 75.1mL/min respectively, P<0.01). In acromegalicpatients, surgical remission was accompanied by a significant decline in the eGFR (from 99.8 to 86.2mL/min, P<0.01). Conversely, in patients with NFoma, the postoperative eGFR did not change significantly (from 75.1 to 81.9mL/min, P=0.12). Among the acromegalicpatients, the postoperative decreases in the eGFR were more prominent in patients with a preoperatively high or normal vs low eGFR. CONCLUSIONS: Our data demonstrated a significant post-surgical eGFR decrease in patients with acromegaly, but not in patients with NFomas. This change in the eGFR was reversible in acromegalicpatients with a high/normal preoperative eGFR, but not in those with a low preoperative eGFR. This suggests that the reversible pathophysiological change in some patients is functional but not organic.