Investigation of the efficacy of 99 mTc-DTPA scintigraphic GFR measurement with Gates method in the detection of cisplatin-induced nephrotoxicity in comparison with plasma urea and creatinine measurement

Abstract

In this study, we investigated the efficacy of 99mTc-DTPA scintigraphic analysis of GFR with the Gates method in comparison with the measurement of plasma urea and creatinine, in the detection of nephrotoxicity occurred in patients treated with cisplatin.Twenty-six male patients with a mean age of 26.73 ± 6.39 years (age range 15–42) who had seminomatous and nonseminomatous testicular carcinoma were included in our study. The patients received cisplatin with a dose of 20 mg/m² per day for five consecutive days repeated every 21 days. Before starting chemotherapy, immediately after the end of four cycles of chemotherapy and 7 months after the beginning of chemotherapy, plasma urea and creatinine levels were measured and simultaneously scintigraphic GFR estimation using 99 mTc-DTPA with the Gates method was performed. In the measurements done immediately after the chemotherapy, in 18 of the 26 patients GFR levels decreased, in 4 of the 8 remaining patients GFR did not change, and in 4 patients there was an increase in the GFR levels. The changes in the averages of the plasma urea and creatinine levels between measurements done before and after the chemotherapy were not statistically significant. The decrease in the average of the GFR values immediately after chemotherapy, in comparison to the average of GFR values measured before chemotherapy, was found to be statistically significant with paired sample t test analysis (P < 0.009 with 95% CI). We concluded that scintigraphic GFR measurement using the Gates method with 99mTc-DTPA is a suitable method in the diagnosis of nephrotoxicity occuring due to cisplatine.