Advertisement

Revisiting normal 51Cr-ethylenediaminetetraacetic acid clearance values in children

  • A. PiepszEmail author
  • M. Tondeur
  • H. Ham
Original article

Abstract

Purpose

Normal 51Cr-ethylenediaminetetraacetic acid (EDTA) clearance values as a function of age were published a number of years ago. These values were based on data from children with a normal left to right ratio and a normal appearance on DMSA scintigraphy, despite the presence of an acute renal infection. At that time, the authors were unaware that hyperfiltration is a common phenomenon in patients with acute renal infection and that their normal values could have been significantly overestimated. The present work therefore aimed to re-appraise these normal values.

Methods

In a first step, in order to verify the previous results, the same type of population was selected, namely patients with present or past urinary tract infection but normal images and a normal left to right ratio on DMSA scintigraphy. In a second step, the selection was based on patients who had had no recent urinary tract infection. In both series, a single blood sample method was used for the evaluation of 51Cr-EDTA clearance.

Results

In the first group of patients, the results obtained were almost identical to those previously published. In the second group of patients, the results were significantly lower: after 2 years of age, the mean GFR value was 104 ml/min/1.73 m2 (10th and 90th percentiles 81 and 135 ml/min/1.73 m2, respectively), compared with 117 ml/min/1.73 m2 in the first group.

Conclusion

The data of the second group are probably more representative of the true normal GFR values and can be applied to the entire paediatric population.

Keywords

51Cr-EDTA GFR Children Normal values Hyperfiltration 

References

  1. 1.
    Piepsz A, Pintelon H, Ham HR, Piepsz A. Estimation of normal chromium-51 ethylene diamine tetra-acetic acid clearance in children. Eur J Nucl Med 1994;21:12–16PubMedCrossRefGoogle Scholar
  2. 2.
    Arnello F, Ham HR, Tondeur M, Piepsz A. Overall and single-kidney clearance in children with urinary tract infection and damaged kidneys. J Nucl Med 1999;40:52–55PubMedGoogle Scholar
  3. 3.
    Arnello F, Ham HR, Tondeur M, Piepsz A. Evolution of single kidney glomerular filtration rate in urinary tract infection. Pediatr Nephrol 1999;13:121–124PubMedCrossRefGoogle Scholar
  4. 4.
    Ham H, Piepsz A. Estimation of glomerular filtration rate in infants and in children using a single-plasma sample method. J Nucl Med 1991;32:1294–1297PubMedGoogle Scholar
  5. 5.
    Chantler C, Barratt T. Estimation of glomerular filtration rate from plasma clearance of 51-chromium edetic acid. Arch Dis Child 1972;47:613–617PubMedCrossRefGoogle Scholar
  6. 6.
    Lythgoe MF, Gordon I, Anderson PJ. Effect of renal maturation on the clearance of technetium-99m mercaptoacetyltriglycine. Eur J Nucl Med 1994;21:1333–1337PubMedCrossRefGoogle Scholar
  7. 7.
    Smith HW. The kidney: structure and function in health and disease. New York:Oxford University Press; 1953Google Scholar
  8. 8.
    Bucht H. Studies on renal function in man with special reference to glomerular filtration and renal plasma flow in pregnancy. Scand J Clin Lab Invest 1951;3 (Suppl 3):1–13PubMedGoogle Scholar
  9. 9.
    Brun C, Gormsen H, Hilden T, Raaschouf F. Diabetic nephropathy; kidney biopsy and renal function tests. Am J Med 1953;15:187–197PubMedCrossRefGoogle Scholar
  10. 10.
    Aurell M. Renal clearance of 51Cr-EDTA-complex. Strahlentherapie 1968;67:420–424Google Scholar
  11. 11.
    Berglund G, Aurell M, Wihelmsen L. Renal function in normo- and hypertensive 50-year-old males. Acta Med Scand 1976;199:25–30PubMedCrossRefGoogle Scholar
  12. 12.
    Bröchner-Mortensen J, Rödbro P. Selection of routine methods for determination of glomerular filtration rate in adult patients. Scand J Clin Lab Invest 1976;36:35–43PubMedGoogle Scholar
  13. 13.
    Ljungman S, Aurell M, Hartford M, Wikstrand J, Wilhelmsen L, Berglund G. Blood pressure and renal function. Acta Med Scand 1980;208:17PubMedCrossRefGoogle Scholar
  14. 14.
    Granerus G, Aurell M. Reference values for Cr-51 EDTA clearance as a measure of glomerular filtration rate. Scand J Clin Lab Invest 1981;41:611–616PubMedGoogle Scholar
  15. 15.
    Gross JL , Friedman R, Azevedo MJ, Silveiro SP, Pecis M. Effect of age on glomerular filtration rate measured by Cr-51 EDTA. Braz J Med Biol Res 1992;25:129–134PubMedGoogle Scholar
  16. 16.
    Tonshoff B, Nowack R, Kurilenko S, Blum WF, Seyberth HW, Mehls O, Ritz E. Efficacy and safety of growth hormone treatment in short children with renal allografts: three year experience. Members of the German Study Group for Growth Hormone Treatment in Children with Renal Allografts. Kidney Int 1993;44:199–207PubMedGoogle Scholar
  17. 17.
    Orlando R, Floreani M, Padrini R, Palatini P. Determination of inulin clearance by bolus intravenous injection in healthy subjects and ascitic patients:equivalence of systemic and renal clearances as glomerular filtration markers. Br J Clin Pharmacol 1998;46:605–609PubMedCrossRefGoogle Scholar
  18. 18.
    Herrera J, Rodriguez-Iturbe B. Stimulation of tubular secretion of creatinine in health and in conditions associated with reduced nephron mass. Evidence for a tubular functional reserve. Nephrol Dial Transplant 1998;13:623–629PubMedCrossRefGoogle Scholar
  19. 19.
    Price DA, Fisher NDL, Osei SY, Lansang MC, Hollenberg NK. Renal perfusion and function in healthy African Americans. Kidney Int 2001;59:1037–1043PubMedCrossRefGoogle Scholar
  20. 20.
    Vervoort G, Willems HL, Wetzels JFM. Assessment of glomerular filtration rate in healthy subjects and normoalbuminuric diabetic patients : validity of a new (MDRD) prediction equation. Nephrol Dial Transplant 2002;17:1909–1913PubMedCrossRefGoogle Scholar
  21. 21.
    Lin J, Knight EL, Hogan ML, Singh AK. A comparison of prediction equations for estimating glomerular filtration rate in adults without kidney disease. J Am Soc Nephrol 2003;14:2573–2580PubMedCrossRefGoogle Scholar
  22. 22.
    Gurmandeep S, Grewal S, Blake GM. Reference data for Cr-51 EDTA measurements of the glomerular filtration rate derived from live kidney donors. Nucl Med Commun 2005;26:61–65CrossRefGoogle Scholar
  23. 23.
    Blake GM, Gardiner N, Gnanasegaran G, Dizdarevic S. Reference ranges for 51Cr-EDTA measurements of glomerular filtration rate in children. Nucl Med Commun 2005;26:983–987PubMedCrossRefGoogle Scholar
  24. 24.
    Fleming JS, Nunan TO, British Nuclear Medicine Society. The new BNMS guidelines for measurement of glomerular filtration rate. Nucl Med Commun 2004;25:755–757PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.CHU St PierreDepartment of RadioisotopesBrusselsBelgium
  2. 2.UZ GhentDepartment of Nuclear MedicineGhentBelgium

Personalised recommendations