Abstract
For many years iodide-131 Hippuran has been used as a tracer to measure effective renal plasma flow (ERPF). Because of the low renal clearance of free131-Iiodide and the inability to count it separately from131I-Hippuran, free131I-iodide will lower the calculated131I-Hippuran clearance, resulting in a lower estimated ERPF. This study was performed to establish the maximum allowable radiochemical impurity of free131I-iodide in131I-Hippuran preparations for ERPF measurements in continuous clearance studies. A known amount of123I-iodide was added to the (131I-iodide-free)131I-Hippuran solution used for continuous infusion clearance studies in nine patients.123I-iodide activity was used because it can be counted separately from131I-Hippuran in the infusion solutions and plasma samples while it behaves exactly like131I-iodide, so that the results obtained with123I-iodide can be extrapolated to131I-iodide. After performing the clearance studies, the ERPF was calculated firstly with131I-Hippuran activity only (=true ERPF) and secondly including the free radioactive iodide activity (=false ERPF) in the clearance formula. As expected, if free131I-iodide is present in the infusion solution, its concentration in plasma will be highest at the end of the clearance study. The131I-iodide concentration in plasma relative to the131I-Hippuran concentration will be higher in patients with high ERPF values.131I-iodide in the infusion solution causes a fall in the ERPF as measured by the continuous infusion technique: 0.5%, 1% and 2% of free131I-iodide in the infusion solution result in a reduction in ERPF of about 1.5%, 3.5% and 7% respectively after 1.5 h and of 3.5%, 6.5% and 13% respectively after 5.5 h if ERPF is high. It is concluded that a maximum of 0.5% of free131I-iodide in131I-Hippuran preparations is permissible if ERPF is to be measured with an error of less than 5%.
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Kengen, R.A.M., Meijer, S., van Zanten, A.K. et al. Iodine-131 Hippuran for the estimation of renal plasma flow: requirements for radiochemical purity. Eur J Nucl Med 22, 678–681 (1995). https://doi.org/10.1007/BF01254570
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DOI: https://doi.org/10.1007/BF01254570