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Comparison of methods for determination of glomerular filtration rate: Tc-99m-DTPA renography, predicted creatinine clearance method and plasma sample method

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Abstract

Background: The gamma camera uptake method with Tc-99m-DTPA is simple and less time consuming for the determination of the glomerular filtration rate (GFR). However, its diagnostic accuracy is debated. Gates’ method and predicted creatinine clearance method were compared with plasma clearance method with Tc-99m-DTPA for the measurement of GFR.Materials and Methods: Tc-99m-DTPA renography was performed on 133 patients (69 males and 64 females; age range being 24 to 84 years) with a wide range of renal function. The GFR was determined simultaneously by 3 methods; (1) gamma camera uptake method (modified Gates, Gates); (2) predicted creatinine clearance method (Cockcroft-Gault, CG); (3) single- or two-plasma clearance method (plasma sample clearance method, PSC). The PSC was chosen as a reference.Results: The regression equation of the Gates and the CG against the PSC wasY=11.89 + 1.041X (r=0.790, p<0.001, RMSE=23.55 ml/min/1.73 m2) andY=8.845+0.7899X (r=0.8270, p<0.001, RMSE =16.27 ml/min/1.73 m2), respectively. In comparison with the GFR by PSC, the Gates tended to everestimate the GFR, and contrarily the CG tended to underestimate the GFR.Conclusion: The Gates correlates well with the PSC. However, the Gates is even less precise than the CG. The Gates’ method in Tc-99m-DTPA renography is not suitable for the estimation of GFR in routine practice.

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References

  1. Shemesh O, Golbetz H, Kriss JP, Myers BP. Limitations of creatinine as a filtration marker in glomerulopathic patients.Kidney Int 1985; 28: 830–838.

    Article  PubMed  CAS  Google Scholar 

  2. Perrone RD, Madias NE, Levey AS. Serum creatinine as an index of renal function: new insights into old concepts.Clin Chem 1992; 38: 1933–1953.

    PubMed  CAS  Google Scholar 

  3. Rahn KH, Heidenreich S, Bruckner D. How to assess glomerular function and damage in humans.J Hypertension 1999; 17: 308–317.

    Article  Google Scholar 

  4. Swan SK. The search continues—an ideal marker of GFR [editorial].Clin Chem 1997; 43: 913–914.

    PubMed  CAS  Google Scholar 

  5. Prigent A, Cosgriff P, Gates GF, Granerus G, Fine EJ, Itoh K, et al. Consensus report on quality control of quantitative measurements of renal function obtained from the renogram: International consensus committee from the Scientific Committee of Radionuclides in Nephrourology.Semin Nucl Med 1999; 29: 146–159.

    Article  PubMed  CAS  Google Scholar 

  6. Gates GF. Glomerular filtration rate: Estimation from fractional renal accumulation of99mTc-DTPA (stannous).AJR 1982; 138: 565–570.

    PubMed  CAS  Google Scholar 

  7. Russell CD, Bischoff PG, Kontzen F, Rowell KL, Yester MV, Lloyd LK, et al. Measurement of glomerular filtration rate using99mTc-DTPA and the gamma camera: a comparison of methods.Eur J Nucl Med 1985; 10: 519–521.

    Article  PubMed  CAS  Google Scholar 

  8. Fawdry RM, Grueneward SM, Collins LT, Roberts AJ. Comparative assessment of techniques for estimation of glomerular filtration rate with Tc-99m-DTPA.Eur J Nucl Med 1985; 11: 7–12.

    Article  PubMed  CAS  Google Scholar 

  9. Russell CD, Dubovsky EV. Gates method for GFR measurement [letters to the editor].J Nucl Med 1986; 27: 1373–1374.

    PubMed  CAS  Google Scholar 

  10. Russell CD. Estimation of glomerular filtration rate using99mTc-DTPA and the gamma camera.Eur J Nucl Med 1987; 12: 548–552.

    Article  PubMed  CAS  Google Scholar 

  11. Mulligan JS, Blue PW, Hasbargen JA. Methods for measuring GFR with technetium-99m-DTPA: an analysis of several common methods.J Nucl Med 1990; 31: 1211–1219.

    PubMed  CAS  Google Scholar 

  12. Goates JJ, Morton KA, Whooten WW, Greenberg HE, Datz FL, Handy JE, et al. Comparison of methods for calculating glomerular filtration rate: technetium-99m-DTPA scintigraphic analysis, protein-free and whole-plasma clearance of technetium-99m-DTPA and iodine-125-iothalamate clearance.J Nucl Med 1990; 31: 424–429.

    PubMed  CAS  Google Scholar 

  13. Duran E, Prigent A, Gaillard J. Comparison between 9 methods for estimation of glomerular filtration rate (GFR) with simultaneous injection of51Cr-EDTA and99mTc-DTPA. In: Taylor A Jr, Nally J, Thomsen H (eds),Radionuclides in Nephrourology, Reston, VA: Society of Nuclear Medicine, 1997; 112–120.

    Google Scholar 

  14. De Santo NG, Anastasio P, Cirillo M, Santoro D, Spitali L, Mansi L, et al. Measurement of glomerular filtration rate by the99mTc-DTPA renogram is less precise than measured and predicted creatinine clearance.Nephron 1999; 81: 136–140.

    Article  PubMed  Google Scholar 

  15. Itoh K, Tsushima S, Tsukamoto E, Tamaki N. Reappraisal of single-sample and gamma camera methods for determination of the glomerular filtration rate with99mTc-DTPA.Ann Nucl Med 2000; 14: 143–150.

    Article  PubMed  CAS  Google Scholar 

  16. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine.Nephron 1976; 16: 31–41.

    Article  PubMed  CAS  Google Scholar 

  17. Brochner-Mortensen J. Routine methods and their reliability for assessment of glomerular filtration rate in adults with special reference to total [51Crxx]EDTA plasma clearance.Dan Med Bull 1978; 25: 181–202.

    PubMed  CAS  Google Scholar 

  18. Brochner-Mortensen J. Current status on assessment and measurement of glomerular filtration rate.Clin Physiol 1983; 8: 1–17.

    Google Scholar 

  19. Levey AS. Use of measurements of GFR to assess the progression of renal disease.Semin Nephrol 1989; 9: 370–378.

    PubMed  CAS  Google Scholar 

  20. Blaufox MD, Aurell M, Bubeck B, Fommei E, Piepsz A, Russell C, et al. Report of the Radionuclides in Nephrourology Committee on renal clearance.J Nucl Med 1996; 37: 1883–1890.

    PubMed  CAS  Google Scholar 

  21. Itoh K. Determination of glomerular filtration rate by means of newly developed plastic scintillation counter both with and without dilution procedures.J Nucl Med 2001; 42: 1484–1488.

    PubMed  CAS  Google Scholar 

  22. Christensen AB, Groth S. Determination of99mTc-DTPA clearance by single plasma sample method.Clin Physiol 1992; 19: 827.

    Google Scholar 

  23. Watson WS. A simple method of estimating glomerular filtration rate [letters to the editor].Eur J Nucl Med 1992; 19: 827.

    Article  PubMed  CAS  Google Scholar 

  24. Itoh K, Tsushima S, Tsukamoto E, Tamaki N. Accuracy of plasma sample method for determination of glomerular filtration rate with99mTc-DTPA.Ann Nucl Med 2002; 16: 39–44.

    Article  PubMed  Google Scholar 

  25. Brochner-Mortensen J. A simple method for the determination of glomerular filtration rate.Scand J Clin Lab Invest 1972; 30: 271–274.

    Article  PubMed  CAS  Google Scholar 

  26. Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children and adults.J Pediatrics 1978; 93: 62–66.

    Article  CAS  Google Scholar 

  27. Bland JM, Altman D. Statistical methods for assessing agreement between two methods of clinical measurement.Lancet 1986; ii: 307–310.

    Article  Google Scholar 

  28. Russell CD. In: Tauxe WN, Dubovsky EV (eds),Nuclear Medicine in Clinical Urology and Nephrology, Norwalk, CT; Appleton-Century-Crofts, 1985: 173–184.

    Google Scholar 

  29. Petersen LJ, Petersen JR, Talleruphuus U, Moller TA, Ladefoged SD, Mehlsen J, et al. Glomerular filtration rate estimated from the uptake phase of99mTc-DTPA renography in chronic renal failure.Nephrol Dial Transplant 1999; 14: 1673–1678.

    Article  PubMed  CAS  Google Scholar 

  30. Rehling M, Moller ML, Lund JO, Jensen KB, Thamdrup B, Trap-Jensen J.99mTc-DTPA gamma-camera renography: normal values and rapid determination of single-kidney glomerular filtration rate.Eur J Nucl Med 1985; 11: 1–6.

    Article  PubMed  CAS  Google Scholar 

  31. Woolfson RG, Neild GH. Renal nuclear medicine: can it survive the millennium?Nephrol Dial Transplant 1998; 13: 12–14.

    Article  PubMed  CAS  Google Scholar 

  32. Lewis R, Kerr N, Van Buren C, Lowry P, Sandler C, Fraser OH, et al. Comparative evaluation of urographic contrast media, inulin, and99mTc-DTPA clearance methods for determination of glomerular filtration rate in clinical transplantation.Transplantation 1989; 48: 790–796.

    Article  PubMed  CAS  Google Scholar 

  33. Rehling M, Moller ML, Thamdrup B, Lund JO, Trap-Jensen J. Simultaneous measurement of renal clearance and plasma clearance of99mTc-labelled diethylenetriaminepentaacetate,51Cr-labelled ethylen-diaminetetra-acetate and inulin in man.Clin Sci 1984; 66: 613–619.

    PubMed  CAS  Google Scholar 

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  1. Department of Radiology, JR Sapporo General Hospital, Higashi-1, Kita-3, Chuo-ku, 060-0033, Sapporo, Japan

    Kazuo Itoh

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Itoh, K. Comparison of methods for determination of glomerular filtration rate: Tc-99m-DTPA renography, predicted creatinine clearance method and plasma sample method. Ann Nucl Med 17, 561–565 (2003). https://doi.org/10.1007/BF03006669

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