The clinical significance of glomerular filtration rate measured by 99Tcm-diethylentriamine pentaacetic acid renal dynamic imaging in renal cercinoma patients before surgeru

Abstract

Objective To investigate the clinical significance of glomerular filtration rate(GFR)measured by 99Tcm-diethylenetriamine pentaacetic acid(99Tcm-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).99Tcm-DTPA renal dynamic imaging was performed for determining GFR before surgery.Make a comparison of GFR 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 X2-text.Results Compared with contral group,total GFR of RCC patients was lower,but there was no significant 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 133μmol/L).There was no significant difference in GFR of neoplastic 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%,X2=6.808,P<0.01).Conclusion GFR can provide the accurate information of both kidneys and single kidney before surgery,and this result possessed an important significance in choice of treatments. Key words: Kidney neoplasms; Glomerular filtration rate; Technetium Tc 99m pentetate; Tomography,emission-computed,single-photon