Can eGFR be a routine preoperative renal function test?

The creatinine clearance (Ccr) test has been used as a gold standard for evaluation of preoperative renal function in patients with gastric cancer. However, it is known that Ccr is not strictly equivalent to glomerular filtration rate (GFR). It has been accepted that estimated GFR (eGFR) is equal to measured GFR in chronic kidney disease. However, there have been no studies regarding the reliability of eGFR as a preoperative renal function test in gastric cancer patients.

A research article to be published on May 21, 2010 in the World Journal of Gastroenterology addresses this question. The research team from Second Department of Surgery, Dokkyo Medical University, Japan, analyzed Ccr and eGFR retrospectively in a series of gastric cancer patients.

Among 110 patients with normal preoperative Ccr values, 7 (6.3%) had abnormal postoperative sCr values, and among 112 patients with normal preoperative eGFR values, postoperative sCr was abnormal in 5 (4.5%). Among 37 patients with abnormal preoperative Ccr values, 30 (81.1%) had normal postoperative sCr values, and of 35 patients with abnormal preoperative eGFR values, postoperative sCr was normal in 25 (71.4%). Preoperative Ccr was significantly correlated with eGFR, and postoperative sCr was significantly correlated with preoperative Ccr and eGFR.

The authors concluded that eGFR is as equally valuable as Ccr as an indicator of preoperative renal function in patients with gastric cancer, and that eGFR may now be used in place of Ccr in view of the former’s clear medical and socioeconomic advantages.

Reference: Kosuge T, Sawada T, Iwasaki Y, Kita J, Shimoda M, Tagaya N, Kubota K. eGFR is a reliable preoperative renal function parameter in patients with gastric cancer. World J Gastroenterol 2010; 16(19): 2417-2420

http://www.wjgnet.com/1007-9327/full/v16/i19/2417.htm

Correspondence to: Tokihiko Sawada, Associate Professor, Second Department of Surgery, Dokkyo Medical University, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi 321-0293, Japan. [email protected]

Telephone: +81-282-861111 Fax: +81-282-866317

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.


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