title: Treatable glomerular hyperfiltration in patients with active acromegaly.
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.
  
  
  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.
authors.affiliation: Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan ofuji@m2.kufm.kagoshima-u.ac.jp.
authors.forename: Shingo
authors.initials: S
authors.lastname: Fujio
authors.affiliation: Department of EndocrinologyDiabetes and Metabolism, School of Medicine, Kitasato University, Sagamihara, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Takano
authors.affiliation: Department of DiabetesMetabolism and Endocrinology.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Arimura
authors.affiliation: Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Habu
authors.affiliation: Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Manoj
authors.initials: M
authors.lastname: Bohara
authors.affiliation: Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Horofumi
authors.initials: H
authors.lastname: Hirano
authors.affiliation: Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hanaya
authors.affiliation: Department of DiabetesMetabolism and Endocrinology.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Nishio
authors.affiliation: Department of Epidemiology and Preventive MedicineGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Chihaya
authors.initials: C
authors.lastname: Koriyama
authors.affiliation: Department of NeurosurgeryGraduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kinoshita
authors.affiliation: Department of NeurosurgeryGraduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Arita
mesh_terms: D000172:Acromegaly / Q000503:physiopathology* / Q000601:surgery; D000236:Adenoma / Q000503:physiopathology* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult