Estimated glomerular filtration rate is superior to measured creatinine clearance for predicting postoperative renal dysfunction 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 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.
Department of Gastroenterological Surgery, Dokkyo Medical University, Mibu, Tochigi, Japan. yiwasaki@dokkyomed.ac.jp
Yoshimi
Y
Iwasaki
Tokihiko
T
Sawada
Hiroaki
H
Kijima
Takayuki
T
Kosuge
Masato
M
Katoh
Kyu
K
Rokkaku
Junji
J
Kita
Mitsugi
M
Shimoda
Keiichi
K
Kubota
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D014670:Ampulla of Vater / Q000473:pathology / Q000601:surgery; D001806:Blood Urea Nitrogen; D003137:Common Bile Duct Diseases / Q000601:surgery; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010182:Pancreatic Diseases / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
D003404:Creatinine