Abstract:
Objective To evaluate the clinical value of total and half glomerular filtration rate (GFR) measured through 99Tcm-DTPA renal dynamic imaging during radical nephrectomy.
Methods The total and half GFRs of 60 patients with renal tumors were measured and analyzed through renal dynamic imaging prior to surgery. The patients were divided into two groups in accordance with renal tumor diameter (≥ 4 cm or < 4 cm). Then, the correlation between decreased preoperative GFR and tumor size was determined. Univariate and multivariate analyses were performed to detect the predictors of renal insufficiency for the evaluation of the clinical value of total and half GFRs in operated patients.
Results The average GFR of the affected kidney in the group with tumors less than 4 cm in diameter was (52.94±8.57) mL/min, whereas that of the group with tumors greater than 4 cm in diameter was (45.78±13.27) mL/min. The preoperative GFR of the affected side (t=2.152, P < 0.05) of the two groups were significantly different. Meanwhile, the preoperative GFR of the unaffected side and total kidney of the two groups were not significantly different (t=1.852, 1.255, both P>0.05). The ratio of postoperative new renal insufficiency was 21.6%. Univariate and multivariate analyses showed that the decreased preoperative GFR of the unaffected side (OR=3.6, P < 0.05) and total kidney (OR=5.64, P < 0.05) are independent risk factors of postoperative renal insufficiency.
Conclusion Total and half renal functions determined through renal dynamic imaging are clinically valu-able in the preoperative direction and evaluation of renal insufficiency.