Predicting postoperative renal insufficiency in patients undergoing nephrectomy for renal malignancy: Assessment by renal scintigraphy using 99mtechnetium-mercaptoacetyltriglycine

Yoshinori Shirasaki, Takashi Saika, Tomoyasu Tsushima, Yasutomo Nasu, Ryoji Arata, Hiromi Kumon

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Abstract

Purpose: We performed 99mTc-mercaptoacetyltriglycine (MAG3) renal scintigraphy in patients with renal malignancy to evaluate the function of each renal unit before and after nephrectomy to see if postoperative functional deterioration could be predicted based on scintigraphy results and creatinine clearance. Materials and Methods: A total of 22 men and 13 women with renal malignancy, including 32 with renal cell carcinoma and 3 with urothelial cancer, were prospectively enrolled in this study. Average patient age was 64.3 years (median 65, range 43 to 88). All patients underwent MAG3 renal scintigraphy before and after unilateral nephrectomy. At the same time serum creatinine and endogenous creatinine clearance were determined. Results: Mean serum creatinine was 0.93 mg/dl before and 1.31 after nephrectomy (p 2, which decreased to 49.0 ml per minute per 1.73 m2 after nephrectomy (p 2 following nephrectomy. Spearman rank core analysis revealed that preoperative MAG3 clearance of the remaining kidney significantly correlated with postoperative creatinine clearance (r = 0.596, p = 0.0005). Preoperative MAG3 clearance of the remaining kidney more than 130 ml per minute per 1.73 m 2 coincided with postoperative creatinine clearance above 40 ml per minute per 1.73 m2. Conclusions: MAG3 renal scintigraphy may be useful for predicting renal insufficiency after nephrectomy. The findings in this study suggest that preoperative MAG3 clearance of the remaining kidney less than 130 ml per minute per 1.73 m2 is a risk factor for postoperative renal insufficiency.

Original languageEnglish
Pages (from-to)388-390
Number of pages3
JournalJournal of Urology
Volume173
Issue number2
DOIs
Publication statusPublished - Feb 2005

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Nephrectomy
Radionuclide Imaging
Renal Insufficiency
Kidney
Creatinine
Neoplasms
Technetium Tc 99m Mertiatide
Serum
Renal Cell Carcinoma

Keywords

  • Creatinine
  • Kidney
  • Kidney neoplasms
  • Nephrectomy
  • Radionuclide imaging

ASJC Scopus subject areas

  • Urology

Cite this

Predicting postoperative renal insufficiency in patients undergoing nephrectomy for renal malignancy : Assessment by renal scintigraphy using 99mtechnetium-mercaptoacetyltriglycine. / Shirasaki, Yoshinori; Saika, Takashi; Tsushima, Tomoyasu; Nasu, Yasutomo; Arata, Ryoji; Kumon, Hiromi.

In: Journal of Urology, Vol. 173, No. 2, 02.2005, p. 388-390.

Research output: Contribution to journalArticle

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N2 - Purpose: We performed 99mTc-mercaptoacetyltriglycine (MAG3) renal scintigraphy in patients with renal malignancy to evaluate the function of each renal unit before and after nephrectomy to see if postoperative functional deterioration could be predicted based on scintigraphy results and creatinine clearance. Materials and Methods: A total of 22 men and 13 women with renal malignancy, including 32 with renal cell carcinoma and 3 with urothelial cancer, were prospectively enrolled in this study. Average patient age was 64.3 years (median 65, range 43 to 88). All patients underwent MAG3 renal scintigraphy before and after unilateral nephrectomy. At the same time serum creatinine and endogenous creatinine clearance were determined. Results: Mean serum creatinine was 0.93 mg/dl before and 1.31 after nephrectomy (p 2, which decreased to 49.0 ml per minute per 1.73 m2 after nephrectomy (p 2 following nephrectomy. Spearman rank core analysis revealed that preoperative MAG3 clearance of the remaining kidney significantly correlated with postoperative creatinine clearance (r = 0.596, p = 0.0005). Preoperative MAG3 clearance of the remaining kidney more than 130 ml per minute per 1.73 m 2 coincided with postoperative creatinine clearance above 40 ml per minute per 1.73 m2. Conclusions: MAG3 renal scintigraphy may be useful for predicting renal insufficiency after nephrectomy. The findings in this study suggest that preoperative MAG3 clearance of the remaining kidney less than 130 ml per minute per 1.73 m2 is a risk factor for postoperative renal insufficiency.

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