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Usefulness of a Pretreatment CT-Based Modified RENAL Nephrometry Score in Predicting Renal Function After Cryotherapy for T1a Renal Mass.
CardioVascular and Interventional Radiology ( IF 2.8 ) Pub Date : 2019-05-11 , DOI: 10.1007/s00270-019-02238-1
Yoshiki Asayama 1 , Akihiro Nishie 2 , Yasuhiro Ushijima 2 , Daisuke Okamoto 2 , Koichiro Morita 2 , Seiichiro Takao 2 , Daisuke Kakihara 2 , Keisuke Ishimatsu 2 , Kousei Ishigami 2 , Nobuhiro Fujita 2 , Hiroshi Honda 2
Affiliation  

PURPOSE We investigated the usefulness of the modified RENAL nephrometry (mRN) scoring system for predicting post-cryotherapy renal function in patients with T1a renal mass. PATIENTS AND METHODS A total of 75 patients with a T1a renal mass were enrolled. The mRN score was determined based on the tumor size, the tumor's exophytic/endophytic properties, the tumor's nearness to the collecting system, and the anterior/posterior location of the kidney. The change in the estimated glomerular filtration rate (ΔeGFR) was calculated as follows: ΔeGFR = 100 × ([pretreatment eGFR - eGFR at 6 months after cryotherapy]/pretreatment eGFR). Based on the ΔeGFR results, we classified the patients into two groups: a preserved renal function group (ΔeGFR < 10%) and an impaired renal function group (ΔeGFR ≥ 10%). We then analyzed the relationships between the mRN score and ΔeGFR and between the mRN score and the chronic kidney disease (CKD) stage. RESULTS The mean ΔeGFR for all patients was 5.5%. The mRN scores of the preserved renal function group (5.8 ± 0.3) were significantly lower than those of the impaired group (7.4 ± 0.3) (p < 0.001). When the mRN score cutoff value was set at 7 points, the mRN had 67.7% sensitivity, 72.7% specificity, 61.8% positive predictive value (PPV), 76.1% negative predictive value (NPV), and 70.7% accuracy for predicting impaired renal function. For predicting a deterioration of CKD stage, the mRN had 92.9% sensitivity, 67.2% specificity, 39.4% PPV, 97.6% NPV, and 72% accuracy. CONCLUSION Our newly proposed modified RENAL nephrometry score was suggested to be useful for predicting renal function after renal cryotherapy.

中文翻译:

T1a肾肿块冷冻治疗后,基于CT的预处理RENAL肾功能评分对预测肾功能的有用性。

目的我们研究了改良的RENAL肾病评分系统(mRN)评分系统在预测T1a肾病患者冷冻治疗后肾功能中的作用。患者与方法共有75例T1a肾肿患者入组。根据肿瘤大小,肿瘤的外生/内生特性,肿瘤与收集系统的距离以及肾脏的前/后位置确定mRN评分。估算的肾小球滤过率(ΔeGFR)的变化计算如下:ΔeGFR= 100×([冷冻治疗后6个月的预处理eGFR-eGFR] /预处理eGFR)。根据ΔeGFR结果,我们将患者分为两组:保留的肾功能组(ΔeGFR<10%)和受损的肾功能组(ΔeGFR≥10%)。然后,我们分析了mRN评分与ΔeGFR之间以及mRN评分与慢性肾脏病(CKD)阶段之间的关系。结果所有患者的平均ΔeGFR为5.5%。保留肾功能组的mRN评分(5.8±0.3)显着低于受损组(7.4±0.3)(p <0.001)。当mRN得分临界值设为7分时,mRN预测肾功能受损的敏感性为67.7%,特异性为72.7%,阳性预测值(PPV)为61.8%,阴性预测值(NPV)为76.1%,准确度为70.7%。 。为了预测CKD期的恶化,mRN的敏感性为92.9%,特异性为67.2%,PPV为39.4%,NPV为97.6%,准确度为72%。结论我们新提出的改良RENAL肾功能评分对预测肾脏冷冻治疗后的肾功能有用。
更新日期:2019-05-09
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