The clinical significance of glomerular filtration rate measured by ⁹⁹T^cm-diethylentriamine pentaacetic acid renal dynamic imaging in renal cell carcinoma patients before surgery

Objective To investigate the clinical significance of glomerular filtration rate(GFR) measured by⁹⁹Tc^m-diethylenetriamine pentaacetic acid(⁹⁹Tc^m-DTPA)renal dynamic imaging in renal cell carcinoma(RCC)patients before surgery.

Methods There were 99 cases of RCC patients, 89 patients undergoing radical nephrectomy(RN)and 10 patients undergoing nephron-sparing surgery(NSS).⁹⁹Tc^m-DTPA renal dynamic imagingwas performed for determiningGFR before surgery.Make a comparison ofGFR between RCC group and control group(normal kidney donors), RN group and NSS group.Make a comparison between GFR and serum creatinine in determining preoperative renal dysfunction of RCC patients.All of the data were analyzed by t-test and χ²-text.

Results Compared with contral group, total GFR ofRCC patients was lower, but there was nosignificant difference(76.4±20.4)ml/min vs.(80.6±17.4)ml/min, t=0.650, P > 0.05).Nineteen cases(19.2%)of RCC patients had preoperative renal dysfunction(total GFR < 60 ml/min), but only 4 cases performed abnormal serumcreatinine(> 133 μmol/L).There was no significant difference in GFR ofneoplastic kidneys between RN group and NSS group(34.1±11.7)ml/min vs.(37.9±11.9)ml/min, t=0.975, P > 0.05. GFR of contralateral kidneys was lower in NSS group than RN group(32.7±10.3)ml/min vs.(39.6±10.1) ml/min, t=0.044, P < 0.05.The percentage of preoperative renal dysfunction(total GFR < 60 ml/min)in NSS group was significantly higher than in RN group(50.0% vs.15.7%, χ²=6.808, P < 0.01).

Conclusion GFR can provide the accurate information ofboth kidneys and single kidney before surgery, and this result possessed animportant significance in choice oftreatments.