Advertisement

Clinical and Experimental Nephrology

, Volume 22, Issue 5, pp 1205–1212 | Cite as

Pre-operative and post-operative estimated glomerular filtration rate in Japanese patients with urological malignancies

  • Naoya Niwa
  • Tadashi YoshidaEmail author
  • Ryuichi Mizuno
  • Eiji Kikuchi
  • Akira Miyajima
  • Matsuhiko Hayashi
  • Mototsugu Oya
Original article
  • 139 Downloads

Abstract

Background

The suitable methods evaluating glomerular filtration rate (GFR) have not been established in patients undergoing radical nephrectomy (RN) or radical nephroureterectomy (RNU) due to urological malignancies in Japan as well as worldwide.

Methods

We examined the relationship between creatinine clearance-based measured GFR (mGFR) versus estimated GFR (eGFR) calculated by 3 popular equations, 4-variable Modification of Diet in Renal Disease equation adjusted by Japanese correction coefficient (cmMDRD), 3-variable MDRD equation for Japanese population (eGFRcreat), and Chronic Kidney Disease-Epidemiology Collaboration equation adjusted by Japanese correction coefficient (cmCKD-EPI) in Japanese patients who had undergone RN or RNU due to renal cell carcinoma or upper tract urothelial carcinoma before and after surgery.

Results

Among the 3 equations examined, eGFRcreat was the closest to mGFR, although each eGFR was significantly higher than mGFR in the pre-operative period. In the post-operative period, cmMDRD and eGFRcreat, but not cmCKD-EPI, were comparable to mGFR. Each of eGFR was significantly correlated with mGFR in both the pre-operative and post-operative periods. Similar results were obtained by the subanalysis of the patients with pre-operative mGFR of < 60 mL/min/1.73 m2. Results of κ statistics also showed that eGFRcreat was most appropriate to estimate GFR both before and after heminephrectomy, when cut-off value of GFR of < 60 mL/min/1.73 m2 was used.

Conclusion

Results of the present study suggest that eGFRcreat is likely to be the most appropriate equation for patients undergoing RN or RNU due to urological malignancies. However, more precise equations will be required for accurately estimating GFR.

Keywords

Nephrectomy Nephroureterectomy Glomerular filtration rate Renal cell carcinoma Upper tract urothelial carcinoma 

Notes

Compliance with ethical standards

Funding

None to report.

Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional review board at Keio University Hospital (IRB Approval Number: 20130424) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The informed consent was waived by the institutional review board at Keio University Hospital, since the patients had left the institution at the time of the study and the study subjects were de-identified.

References

  1. 1.
    Kanayama H, Fukumori T, Fujimoto H, Nakanishi H, Ohyama C, Suzuki K, Nishiyama H, Eto M, Miki T, Kamoi K, Kubota Y, Takahashi S, Homma Y, Naito S. Clinicopathological characteristics and oncologial outcomes in patients with renal cell carcinoma registered in 2007: the first large-scale multicenter study from the cancer registration committee of the Japanese urological association. Int J Urol. 2015;22:S1-S7.CrossRefGoogle Scholar
  2. 2.
    Miyazaki J, Nishiyama H. Epidemiology of urothelial carcinoma. Int J Urol. 2017; (In press).Google Scholar
  3. 3.
    Chronic Kidney Disease Prognosis Consortium, Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, Coresh J, Gansevoort RT. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010; 375:2073–81.CrossRefGoogle Scholar
  4. 4.
    Astor BC, Matsushita K, Gansevoort RT, van der Velde M, Woodward M, Levey AS, de Jong PE, Coresh J. Chronic Kidney Disease Prognosis Consortium. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts. Kidney Int. 2011; 79:1331–40.CrossRefGoogle Scholar
  5. 5.
    Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A. Collaborators developing the Japanese equation for estimated GFR. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.CrossRefGoogle Scholar
  6. 6.
    Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F. Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145:247–54.CrossRefGoogle Scholar
  7. 7.
    Stevens LA, Coresh J, Feldman HI, Greene T, Lash JP, Nelson RG, Rahman M, Deysher AE, Zhang YL, Schmid CH, Levey AS. Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol. 2007;18:2749–57.CrossRefGoogle Scholar
  8. 8.
    Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–12.CrossRefGoogle Scholar
  9. 9.
    Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S. Modification of the CKD Epidemiology Collaboration (CKD-EPI) equation for Japanese: accuracy and use for population estimates. Am J Kidney Dis. 2010;56:32 – 8.CrossRefGoogle Scholar
  10. 10.
    Tan JC, Ho B, Busque S, Blouch K, Derby G, Efron B, Myers BD. Imprecision of creatinine-based GFR estimates in uninephric kidney donors. Clin J Am Soc Nephrol. 2010;5:497–502.CrossRefGoogle Scholar
  11. 11.
    Ferreira-Filho SR, Cardoso CC, de Castro LA, Oliveira RM, Sá RR. Comparison of measured creatinine clearance and clearances estimated by Cockcroft-Gault and MDRD formulas in patients with a single kidney. Int J Nephrol. 2011;2011:626178.Google Scholar
  12. 12.
    Macías LB, Poblet MS, Jerez RI, Roncero FM, Blanco GB, Palomo PP, Govantes MA. Study of renal function in living kidney donors: estimated or measured glomerular filtration. Transpl Proc. 2013;45:3612–5.CrossRefGoogle Scholar
  13. 13.
    Mariat C, Maillard N, Phayphet M, Thibaudin L, Laporte S, Alamartine E, Berthoux F. Estimated glomerular filtration rate as an end point in kidney transplant trial: where do we stand?. Nephrol Dial Transpl. 2008; 23:33–8.CrossRefGoogle Scholar
  14. 14.
    White CA, Huang D, Akbari A, Garland J, Knoll GA. Performance of creatinine-based estimates of GFR in kidney transplant recipients: a systematic review. Am J Kidney Dis. 2008;51:1005–15.CrossRefGoogle Scholar
  15. 15.
    Buron F, Hadj-Aissa A, Dubourg L, Morelon E, Steghens JP, Ducher M, Fauvel JP. Estimating glomerular filtration rate in kidney transplant recipients: performance over time of four creatinine-based formulas. Transplantation. 2011;92:1005–11.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Masson I, Flamant M, Maillard N, Rule AD, Vrtovsnik F, Peraldi MN, Thibaudin L, Cavalier E, Vidal-Petiot E, Bonneau C, Moranne O, Alamartine E, Mariat C, Delanaye P. MDRD versus CKD-EPI equation to estimate glomerular filtration rate in kidney transplant recipients. Transplantation. 2013;95:1211–7.CrossRefGoogle Scholar
  17. 17.
    Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41.CrossRefGoogle Scholar
  18. 18.
    Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition. 1989; 5:303–311.PubMedPubMedCentralGoogle Scholar

Copyright information

© Japanese Society of Nephrology 2017

Authors and Affiliations

  • Naoya Niwa
    • 1
  • Tadashi Yoshida
    • 2
    • 3
    Email author
  • Ryuichi Mizuno
    • 1
  • Eiji Kikuchi
    • 1
  • Akira Miyajima
    • 1
  • Matsuhiko Hayashi
    • 2
    • 3
  • Mototsugu Oya
    • 1
  1. 1.Department of UrologyKeio University School of MedicineTokyoJapan
  2. 2.Apheresis and Dialysis CenterKeio University School of MedicineTokyoJapan
  3. 3.Department of General MedicineKeio University School of MedicineTokyoJapan

Personalised recommendations