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Comparison of 51Cr-EDTA and 99mTc-DTPA for glomerular filtration rate measurement

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Journal of Nephrology Aims and scope Submit manuscript

Abstract

Purpose

The production of 51Cr-labelled ethylenediaminetetraacetic acid (51Cr-EDTA), a validated and widely used radio-isotopic tracer for glomerular filtration rate (GFR) measurement in Europe, was recently halted by the manufacturer. Technetium-99m-diethylenetriaminepentaacetic acid (99mTc-DTPA) clearance has so far mostly been restricted to assessment of separate renal function by scintigraphy, but scarcely used and validated for GFR measurement. We compared the performances of 51Cr-EDTA and 99mTc-DTPA for GFR and extracellular fluid measurement.

Methods

In a multi-centre prospective study, 51Cr-EDTA and 99mTc-DTPA were simultaneously injected into 88 patients, and their urinary and plasma clearances, as well as their volumes of distribution, were measured during seven 30-min periods after a 90-min equilibrium time.

Results

Mean age was 52.2 ± 14.5 years, 59% were men. Urinary clearances of 51Cr-EDTA and 99mTc-DTPA were 64.1 ± 27.6 and 66.1 ± 28.0 mL/min, respectively, with a mean bias of 2.00 ± 2.25 mL/min, an accuracy within 10% of 95% [95% CI 91–99], and a coefficient of determination (R2) of 0.994. Plasma clearances of 51Cr-EDTA and 99mTc-DTPA were 66.1 ± 25.8 and 68.1 ± 26.6 mL/min, respectively, with a mean bias of 1.96 ± 3.32 mL/min, an accuracy within 10% of 91% [95% CI 85–97] and a R2 of 0.985. Distribution volumes were 17.3 ± 4.6 L for 51Cr-EDTA and 16.6 ± 4.6 L for 99mTc-DTPA (R2 0.930).

Conclusion

The accuracy and precision of 99mTc-DTPA clearance, compared to 51Cr-EDTA clearance, was excellent for both urinary and plasma clearance methods, despite an approximate 2 mL/min overestimation, showing that the tracer is a reliable alternative to 51Cr-EDTA for GFR measurement.

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Funding

There was no source of funding for this study.

Author information

Author notes

  1. Emmanuelle Vidal-Petiot, Marie Courbebaisse and Marine Livrozet equally contributed.

Authors and Affiliations

  1. Université de Paris, Paris, France

    Emmanuelle Vidal-Petiot, Marie Courbebaisse, Stéphanie Baron, Sébastien Leygnac, François Rouzet, Pascal Houillier & Martin Flamant

  2. Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 46, rue Henri Huchard, 75018, Paris, France

    Emmanuelle Vidal-Petiot & Martin Flamant

  3. Inserm U1149, Center for Research on Inflammation, Paris, France

    Emmanuelle Vidal-Petiot & Martin Flamant

  4. Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, 75015, Paris, France

    Marie Courbebaisse, Stéphanie Baron & Pascal Houillier

  5. Institut Necker-Enfants Malades, INSERM U1151-CNRS UMR8253, Paris, France

    Marie Courbebaisse

  6. Sorbonne Université, Paris, France

    Marine Livrozet, Françoise Montravers & Jean-Philippe Haymann

  7. Physiology Department, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 75020, Paris, France

    Marine Livrozet & Jean-Philippe Haymann

  8. Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 75020, Paris, France

    Gwénaëlle Corrégé, Timofei Rusu & Françoise Montravers

  9. Centre de Recherche Des Cordeliers, INSERM, Université de Paris, 75006, Paris, France

    Stéphanie Baron & Pascal Houillier

  10. Radiopharmacy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital européen Georges-Pompidou, 75015, Paris, France

    Léa Dupont, Clara Balouzet & Corinne Smadja

  11. Department of Nuclear Medicine, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France

    Sébastien Leygnac, Guillaume Pariscoat & François Rouzet

  12. Department of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France

    Sébastien Leygnac

  13. Radiopharmacy Unit, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018, Paris, France

    Guillaume Pariscoat & Jimmy Rose

  14. Inserm U1148, Laboratory for Vascular Translational Research, 75018, Paris, France

    Guillaume Pariscoat & François Rouzet

Authors
  1. Emmanuelle Vidal-Petiot
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  2. Marie Courbebaisse
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  3. Marine Livrozet
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  4. Gwénaëlle Corrégé
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  9. Clara Balouzet
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  14. François Rouzet
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  15. Pascal Houillier
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  16. Jean-Philippe Haymann
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  17. Martin Flamant
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Corresponding author

Correspondence to Emmanuelle Vidal-Petiot.

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Conflict of interest

The authors declare that they have no financial or non-financial competing interests according to the subject and matter of the presented article. Dr. Balouzet reports non-financial support from Curium, outside the submitted work; Dr. Courbebaisse reports grants from Biohealth (Italy), grants from Advicenne (France), grants from Kyowa Kirin (Japan), and personal fees from Alnylam (France), outside the submitted work; Dr. Rouzet reports personal fees from GE Healthcare and grants from Spectrum Dynamics, outside the submitted work. Other authors have no relevant conflicts of interest to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Vidal-Petiot, E., Courbebaisse, M., Livrozet, M. et al. Comparison of 51Cr-EDTA and 99mTc-DTPA for glomerular filtration rate measurement. J Nephrol 34, 729–737 (2021). https://doi.org/10.1007/s40620-020-00932-9

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  • DOI: https://doi.org/10.1007/s40620-020-00932-9

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