CHANGES IN Estimated Glomerular Filtration Rate (eGFR) AFTER TRANSSPHENOIDAL SURGERY IN PATIENTS WITH ACROMEGALY

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 88-129-Acromegaly & Prolactinoma
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-123
Toko Muraoka*, Naomi Hizuka, Izumi Fukuda, Kumiko Asakawa-Yasumoto, Yukiko Ishikawa and Atsuhiro Ichihara
Tokyo Women's Medical University, Tokyo, Japan
[Background]  Growth hormone (GH) excess causes not only enlargement of kidney size but also increase in renal plasma flow and glomerular filtration rate (GFR) in patients with acromegaly.  We previously reported that estimated GFR (eGFR) was more than 90 ml/min/1.73m2 in 50% of patients with acromegaly, and the value was more than 120 ml/min/1.73m2, which indicating hyperfiltration, in 18% of the patients.  We also reported that eGFR decreased within one year after transsphenoidal surgery (TSS) ascociated with decrease of serum GH and IGF-I levels.  However, further post-surgical changes in eGFR have not been elucidated.

[Objective]  In this study, we investigated longer term changes of renal function in patients with acromegaly after TSS.

[Patients and Methods]  We studied 32 patients (M/F 16/16 age: 23-72 y.o) with acromegaly.  All patients met the post-surgical remission criteria (nadir GH level <1ng/ml during 75g OGTT and normal IGF-I).  The changes in eGFR of the patients during 5 years after TSS and relationships between eGFR and levels of GH and IGF-I was investigated.

[Results]  Before TSS, median eGFR was 84.3 ml/min/1.73m2 (range: 55.7-151.3), and it was more than 90 ml/min/1.73m2 in 15 patients.  Median eGFR significantly decreased to 75.4 ml/min/1.73m2 (P<0.05) in one year after TSS.  The eGFR in 2, 3, 4, and 5 years after TSS were 75.2, 75.4, 70.4 and 76.0 ml/min/1.73m2, respectively, indicating that further change was not observed.  Before TSS, there were no significant relationships between eGFR and serum GH and IGF-I levels.  Moreover, there were no significant relationships between decrease in eGFR and decrease in GH and IGF-I levels after TSS.

[Conclusion]  In patients with acromegaly, whose IGF-I levels were within normal range, eGFR decreased within one year after TSS but subsequent deterioration of renal function was not observed.

Nothing to Disclose: TM, NH, IF, KA, YI, AI

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm