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

    Research output: Contribution to journalArticlepeer-review

    23 Citations (Scopus)

    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 <0.0001). Preoperative endogenous creatinine clearance was 70.8 ml per minute per 1.73 m2, which decreased to 49.0 ml per minute per 1.73 m2 after nephrectomy (p <0.0001). Mean MAG3 clearance of the remaining kidney increased 35.1% above baseline from 156.5 to 211.5 ml per minute per 1.73 m2 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

    Keywords

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

    ASJC Scopus subject areas

    • Urology

    Fingerprint

    Dive into the research topics of 'Predicting postoperative renal insufficiency in patients undergoing nephrectomy for renal malignancy: Assessment by renal scintigraphy using <sup>99m</sup>technetium-mercaptoacetyltriglycine'. Together they form a unique fingerprint.

    Cite this