Endourology & Stone Disease(구연) (E-169)

SPECT/CT 기반 eGFR이 요로결석 수술 후 신기능 저하의 독립적인 예측인자이다
분당서울대학교병원 비뇨의학과
송상헌, 이재원, 오종진
Purpose
To determine the whether single-photon emission computed tomography (SPECT/CT) and independently predict post-operative renal function deterioration in patients who underwent retrograde intrarenal surgery (RIRS) for urinary calculi.

Materials and Methods
Retrospective, single institutional data of 90 patients with perioperative SPECT/CT imaging who underwent RIRS from May 2014 to April 2017 were collected. All patients underwent RIRS for renal stones, and SPECT/CT imaging using 99mTc diethylenetriaminepentacetic acid (99mTc-DTPA) was acquired prior to intervention and 3 months after surgery. Clinical parameters including serum creatinine level and serum estimated glomerular filtration rate (eGFR) were further assessed to evaluate predictability using univariate and multivariate regression analysis.

Results
Deterioration of renal function in the affected side was observed in 26.7% (24) patients, with mean eGFR -18.1 (±6.6) in the deterioration group vs. 0.7 (±17.9) in the non-affected group. There was no difference in mean serum creatinine (sCr) change (-0.040 vs. -0.083, p=0.009), but overall serum eGFR was significantly decreased in the deterioration group (-4.6 vs. 7.1, p=0.009). SPECT/CT preoperative eGFR was an independent predictor of renal deterioration on multivariate analysis (OR 1.072, 95% CI 1.002-1.146; p=0.043).

Conclusion
Preoperative eGFR based on SPECT/CT was significantly associated with increased risk for decreased renal function on the affected side. Impaired renal function on preoperative SPECT/CT could be used to select patients for early intervention. Additional large-scale studies are required to further validate our results.
keywords : SPECT/CT, GFR, urinary stone

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