Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy

doi:10.3748/wjg.15.2252

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. May 14, 2009; 15(18): 2252-2257
Published online May 14, 2009. doi: 10.3748/wjg.15.2252

Table 1 Indications for hepatectomy in 197 patients

	Overall	Abnormal Ccr group	Abnormal eGFR3 group	Abnormal eGFR5 group
Malignant tumors
HCC	117	23	15	23
Cholangiocarcinoma	3	1	0	0
Metastatic liver tumor	40	7	7	8
Hilar BDC	12	2	0	1
Gall bladder carcinoma	4	1	2	2
Combined HCC	3	1	1	1
GIST	1	1	1	1
Total	180	36	26	36
Benign diseases
Hepatolithiasis	2	0	0	0
Hepatic cyst	3	0	2	2
Hemagioma	2	0	1	1
Biliary cyst adenoma	3	1	1	1
Cholecystitis	2	0	1	0
Regenerative nodule	2	0	0	0
Donor	3	0	0	0
Total	17	1	5	4
		P = 0.9065	P = 0.4630	P = 0.3889

HCC: Hepatocellular carcinoma; BDC: Biliary duct carcinoma; GIST: Gastrointestinal stromal tumor.

Table 2 Background characteristics on Ccr

	Normal Ccr group (n = 160)	Abnormal Ccr group (n = 37)	P
Age (yr)	66 (30-82)	71 (46-85)	0.0344
Sex (male:female)	116:44	31:6	0.1552
Height (cm)	160.6 (134.5-179.6)	162.4 (133.9-182.7)	0.4109
Weight (kg)	59.2 (33.0-95.6)	61.6 (44.5-93.0)	0.3543
Hepatitis virus (-:+)	76:84	15:22	0.4441
ICGR₁₅ (%)	13 (1-74)	14 (4-49)	0.9085
Preoperative treatment (-:+)	134:26	32:5	0.6804

Hepatitis virus indicates hepatitis B, C, B + C; Preoperative treatment indicates biliary drainage, TAE and portal vein embolization.

Table 3 Background characteristics on eGFR3

	Normal eGFR3 group (n = 160)	Abnormal eGFR3 group (n = 37)	P
Age (yr)	66 (30- 82)	69 (48-85)	0.0887
Gender (male:female)	125:41	22:9	0.6108
Height (cm)	161.0 (133.9-182.7)	160.4 (143.2-173.0)	0.0511
Weight (kg)	59.2 (33.0-93.4)	60.1 (44.6-95.6)	0.1656
Hepatitis virus (-:+)	77:89	14:17	0.9001
ICGR₁₅ (%)	13 (3-74)	13 (1-31)	0.9085
Preoperative treatment (-:+)	138:28	28:3	0.3129

eGFR3: Estimating glomerular filtration rate calculated by 3 factors; ICGR₁₅: Indocyanine green retention rate at 15 min.

Table 4 Background characteristics on eGFR5

	Normal eGFR5 group (n = 157)	Abnormal eGFR5 group (n = 40)	P
Age (yr)	65 (30-82)	71 (55-85)	0.0003
Sex (male:female)	119:38	28:12	0.4521
Height (cm)	161.5 (133.9-182.7)	158.5 (138.0-173.0)	0.0751
Weight (kg)	59.7 (33.0-95.6)	58.4 (44.0-93.0)	0.5478
Hepatitis virus (-:+)	75:82	16:24	0.3788
ICGR₁₅ (%)	13 (3-74)	14 (1-31)	0.6363
Preoperative treatment (-:+)	130:27	36:4	0.2644

Table 5 Preoperative measurements

	sCr (mg/dL)	BUN (mg/dL)	sAlb (g/dL)	Ccr (mL/min)	eGFR3	eGFR5
Overall (n = 197)	0.73 (0.33-1.74)	13 (5-31)	3.3 (2.1-4.4)	76.8 (1.3-226.1)	77.6 (30.7-196.8)	73.9 (29.8-171.0)
Normal Ccr (n = 160)	0.73 (0.33-1.51)	13 (5-30)	3.3 (2.1-4.4)	86.3 (50.0-226.1)	78.3 (36.7-171.0)	75.1 (36.4-171.0)
	P < 0.05	P < 0.05	NS	P < 0.05	P < 0.05	P < 0.05
Abnormal Ccr (n = 37)	0.81 (0.35-1.74)	15 (6-31)	3.3 (2.5-4.0)	34.1 (1.3-49.9)	66.6 (30.7-196.8)	64.5 (29.8-144.6)
Normal eGFR3 (n = 166)	0.71 (0.33-1.04)	13 (5-31)	3.3 (2.1-4.4)	83.6 (1.3-226.1)	80.7 (60.2-196.8)	77.0 (45.9-171.0)
	P < 0.05	P < 0.05	NS	P < 0.05	P < 0.05	P < 0.05
Abnormal eGFR3 (n = 31)	1.05 (0.75-1.74)	17 (9-26)	3.2 (2.1-4.1)	52.4 (11.8-129.1)	52.4 (30.7-59.9)	48.7 (29.8-68.7)
Normal eGFR5 (n = 157)	0.70 (0.33-1.07)	12 (5-22)	3.4 (2.1-4.4)	84.2 (1.3-226.1)	81.0 (58.0-196.8)	78.3 (62.1-171.0)
	P < 0.05	P < 0.05	P < 0.05	P < 0.05	P < 0.05	P < 0.05
Abnormal eGFR5 (n = 40)	0.97 (0.70-1.74)	18 (10-31)	3.1 (2.1-4.1)	53.6 (11.8-129.1)	55.4 (30.7-68.3)	52.6 (29.8-59.9)

Cr: Creatinine; sCr: Serum creatinine; sAlb: Serum albumine; NS: Not significant.

Table 6 Surgical details

	Operative times (min)	Blood loss (mL)	Pringle time (min)	Hepatectomy (minor:major)	Hepatectomy (alone:plus)
Overall (n = 197)	320 (117-806)	590 (0-12762)	42 (5-176)	124:73	160:37
Normal Ccr (n = 160)	320 (117-721)	573 (0-7240)	43 (5-176)	99:61	132:28
	NS	NS	NS	NS	NS
Abnormal Ccr (n = 37)	321 (180-806)	618 (114-12762)	35 (9-98)	25:12	28:9
Normal eGFR3 (n = 166)	323 (117-721)	553 (0-7240)	42 (5-176)	103:63	136:30
	NS	NS	NS	NS	NS
Abnormal eGFR3 (n = 31)	297 (168-806)	680 (126-12762)	46 (12-87)	21:10	24:7
Normal eGFR5 (n = 157)	325 (117-721)	551 (0-7240)	42 (5-176)	97:60	128:29
	NS	P < 0.05	NS	NS	NS
Abnormal eGFR5 (n = 40)	296 (142-806)	694 (126-12762)	44 (11-98)	27:13	32:8

Minor: < 1 segmentectomy; Major: ≥ 1 segmentectomy; Alone: Only hepatectomy; Plus: Hepatectomy with combined surgery.

Table 7 Postoperative measurements

	Post Cr (mg/dL)	Post BUN (mg/dL)	Post Cr rate (%)
Overall (n = 197)	0.87 (0.43-8.43)	18 (7-97)	11.3 (0-88.1)
Normal Ccr (n = 160)	0.85 (0.43-5.71)	17 (7-81)	11.0 (0-88.1)
	P = 0.0936	P = 0.0875	P = 0.8253
Abnormal Ccr (n = 37)	0.95 (0.50-8.43)	20 (10-97)	12.3 (0-79.4)
Normal eGFR3 (n = 166)	0.83 (0.43-5.71)	17 (7-81)	11.4 (0-88.1)
	P < 0.0001	P = 0.0033	P = 0.4575
Abnormal eGFR3 (n = 31)	1.17 (0.70-8.43)	21 (11-97)	9.0 (0-79.4)
Normal eGFR5 (n = 157)	0.81 (0.43-5.71)	16 (7-81)	11.3 (0-88.1)
	P < 0.0001	P < 0.0001	P = 0.8950
Abnormal eGFR5 (n = 40)	1.14 (0.70-8.43)	23 (11-97)	11.5 (0-79.4)

Citation: Iwasaki Y, Sawada T, Mori S, Iso Y, Katoh M, Rokkaku K, Kita J, Shimoda M, Kubota K. Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy. World J Gastroenterol 2009; 15(18): 2252-2257
URL: https://www.wjgnet.com/1007-9327/full/v15/i18/2252.htm
DOI: https://dx.doi.org/10.3748/wjg.15.2252