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Use of Radionuclides to Study Renal Function

Protocol
Part of the Methods in Molecular Medicine™ book series (MIMM, volume 86)

Abstract

Radionuclides have been used to study renal function clinically since the introduction of the radioisotope renogram by Taplin (1) and Kimball (2). This use is mainly directed at the excretory functions of the kidney that involve glomerular filtration and tubular secretion. Glomerular filtration is a process that may be quantified by the measurement of the rate of renal clearance of a particular substance in the blood. The indicator must meet the following criteria: i) free filtration through the glomerular capillary membranes; ii) no secretion or absorption by the renal tubules; iii) no metabolism by the kidney; iv) no binding to plasma proteins; v) nontoxic and inert; and vi) measurable with high accuracy. Radiochemical purity is an additional requirement when radiolabeled agents are used.

Keywords

Positron Emission Tomography Glomerular Filtration Rate Positron Emission Tomography Imaging Renal Blood Flow Effective Renal Plasma Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Taplin, G. V., Meredith, O. M., Kade, H., et al. (1956) The radioisotope reno-gram. An external test for individual kidney function and upper urinary tract patency. J. Lab. Clin. Med. 48, 886.PubMedGoogle Scholar
  2. 2.
    Kimbel, K. H. (1956) Discussion of paper by W. Schlungbaum and H. Billion, in: Radioaktive isotope in Klinik und Forschung. Vortrage Geisteiner Int Symp, Vol. 2 Urban Schwartzenburg, Berlin.Google Scholar
  3. 3.
    Blaufox, M. D., Aurell, M., Bubeck, B., Fommei, E., Piepsz, A., Russell, C., et al. (1996) Report of the radionuclides in nephrourology committee on renal clearance. J. Nucl. Med. 37, 1883–1890.PubMedGoogle Scholar
  4. 4.
    Bueschen, A. J. and Witten, D. M. (1979) Radionuclide evaluation of renal function. Urol. Clin. North Am. 6, 307.PubMedGoogle Scholar
  5. 5.
    Jone, J. and Burnett, P. C. (1974) Creatinine metabolism in human with decreased renal function. Clin. Chem. 20, 1204.Google Scholar
  6. 6.
    Schrier, R. W. (1982) Acute renal failure. JAMA 247, 2515–2518CrossRefGoogle Scholar
  7. 7.
    Tauxe, W. N., Bagchi, A., Tepe, P. G., et al. (1987). Single-sample method for the estimation of GFR in children. J. Nucl. Med. 28, 366–371.PubMedGoogle Scholar
  8. 8.
    Odlind, B., Hallgren, R., Sohtell, M., et al. (1985) Is I-125 iothalamate an ideal marker for glomerular filtration. Kidney Int. 27, 9–16PubMedCrossRefGoogle Scholar
  9. 9.
    Robin, H. A., Hall, R. (1984) Inaccuracy of estimated creatinine clearance for iothalamate GFR. Amer. J. Kidney Disease 4, 48–54Google Scholar
  10. 10.
    Hell, J. E., Guyton, A. C., and Farr, B. M. (1977) A single-injection method for measuring GFR. Am. J. Physiol. 232, F72–F76.Google Scholar
  11. 11.
    Peter, A. M. (1991) Quantification of renal hemodynamics with radionuclides. Eur. J. Nucl. Med. 18, 274–286.Google Scholar
  12. 12.
    Fine, E. J., Axelrod, M., and Blaufox, M. D. (1985) Physiologic aspects of diagnostic renal imaging. Semin. Nephro. 5, 188–207.Google Scholar
  13. 13.
    Russell, C. D. (1993) Optimum sample times for single-injection, multisample renal clearance methods. J. Nucl. Med. 34, 1761–1765.PubMedGoogle Scholar
  14. 14.
    Tauxe, W. N. (1986) Determination of GFR by single plasma sampling technique following injection of radioiodinated diatrizoate. J. Nucl. Med. 27, 45–50.PubMedGoogle Scholar
  15. 15.
    Waller, D. G., Keast, C. M., and Fleming, J. S, et al. (1987) Measurement of GFR with technetium-99m-DTPA: comparison of plasma clearance techniques. J. Nucl. Med. 28, 372–377.PubMedGoogle Scholar
  16. 16.
    Mulligan, J. S., Blue, P. W., and Hasbargen, J. A. (1990) Methods for measuring GFR with Tc-99m-DTPA: An analysis of several common methods J. Nucl. Med. 31, 1211–1219.PubMedGoogle Scholar
  17. 17.
    Jackson, J., Blue, P. W., and Ghead, N. (1985) GFR determined in conjunction with routine renal scanning. Radiol. 154, 203–205.Google Scholar
  18. 18.
    Bianchi C. (1972) Measurement of glomerular filtration rate. Prog. Nucl. Med. 2, 21–53.PubMedGoogle Scholar
  19. 19.
    Marlow, C. G. and Sheppard, G. (1970) Labeled tracer of inulin for physiological measurement. Clin. Chim. Acta. 28, 469.PubMedCrossRefGoogle Scholar
  20. 20.
    Summer, R. E., Concannon, J. P., and Well, C., et al. (1967) Determination of simultaneous effective renal plasma flow and GFR with I-131-oiodohippurate and I-125 allyl inulin. J. Lab. Clin. Med. 69, 919.Google Scholar
  21. 21.
    Tubis, M., Persons, K., and Rawalay, S. S., et al. (1966) The preparation of labeled carbohydrates for biochemical uses. J. Nucl. Med. 7, 338.Google Scholar
  22. 22.
    Foley, T. H., Jones, N. F., and Clapham, W. F. (1966) Renal clearance of Co-57-cyanocobalamine: importance of plasma protein binding. Lancet 2, 86.PubMedCrossRefGoogle Scholar
  23. 23.
    Garnett, E. S., Parsons, V., and Veall, N. (1967) Measurement of GFR in man using a Cr-51 edetic acid complex. Lancet 3, 818.CrossRefGoogle Scholar
  24. 24.
    Favre, H. R. and Wing, A. T. (1968) Simultaneous Cr-51 edetic acid, insulin and endogeneous creatinine in 20 patients with renal diseases. Br. Med. J. 1, 84.PubMedCrossRefGoogle Scholar
  25. 25.
    Chantler, C, Garnett, E. S., and Parson, V. (1969) GFR measurement in man by the single injection method using Cr-51-EDTA. Clin. Sci. 37, 169.PubMedGoogle Scholar
  26. 26.
    McAfee, T. G., Gagne, G., and Atkin, H. L, et al. (1979) Biological distribution and excretion of DTPA labeled with Tc-99m and In-111. J. Nucl. Med. 20, 1273.PubMedGoogle Scholar
  27. 27.
    Barbour, G. L., Crumb, K., and Boyd, M., et al. (1976) Comparison of inulin, iothalamate and Tc-99m-DTPA for measurement of GFR. J. Nucl. Med. 17, 317.PubMedGoogle Scholar
  28. 28.
    Fotopolos, A, Blaufox, MD, Lee, H, et al. (1994) Effect of residual urine on apparent renal clearance in patients with reduced function, in O’Reilly, P. HGoogle Scholar
  29. 29.
    Brochner-Mortensen, J. (1972) A simple method of estimating GFR. Eur. J. Nucl. Med. 19, 827.Google Scholar
  30. 30.
    Watson, W. S. (1992) A simple method of estimating GFR. J. Eur. J. Nucl. Med. 19, 827.Google Scholar
  31. 31.
    Groth, S. and Aasted, M. (1981) Chromium-51 EDTA clearance determined by one plasma sample. Clin. Physiol. 1, 417–425.PubMedCrossRefGoogle Scholar
  32. 32.
    Russell, C. D., Bischoff, P. G., and Kintzen, F. N., et al. (1985) Measurement of GFR: single injection plasma clearance method without urine collection. J. Nucl. Med. 26, 1243–1247.PubMedGoogle Scholar
  33. 33.
    Russell, C. D., Rowell, K., and Scott, J. W. (1986) Quality control of Tc-99m-DTPA: correlation of analytic test with in vivo protein binding in man. J. Nucl. Med. 27, 560–562.PubMedGoogle Scholar
  34. 34.
    Hosain, F. (1974) Quality control of Tc-99m-DTPA by double tracer clearance technique. J. Nucl. Med. 15, 442.PubMedGoogle Scholar
  35. 35.
    Carlsen, J. E., Moller, M. L., and Lund, J. O., et al. (1980) Comparison of four commercial Tc-99m-DTPA preparations used for the measurement of GFR: concise communication. J. Nucl. Med. 21, 126–129.PubMedGoogle Scholar
  36. 36.
    Russell, C. D., Bischoff, P. G., and Rowell, K. L., et al. (1983) Quality control of Tc-99m-DTPA for measurement of glomerular filtration. J. Nucl. Med. 24, 722–727.PubMedGoogle Scholar
  37. 37.
    Li, Y., Lee, H. B., and Blaufox, M. D. (1997) Single-sample methods to measure GFR with Technetium-99m-DTPA. J. Nucl. Med. 38, 1290–1295.PubMedGoogle Scholar
  38. 38.
    Seanewald, K. and Taylor, A. (1993) A pitfall in calculating differential renal function in patients with renal failure. Clin. Nucl. Med. 18, 377–381.CrossRefGoogle Scholar
  39. 39.
    Chatterton, B. E. (1978) Limitations of the single sample tracer method for determining GFR. Br. J. Radiol. 51, 981–985.PubMedCrossRefGoogle Scholar
  40. 40.
    Israelit, A. H., Long, D. C., White, M. G., et al. (1973) Measurement of GFR utilizing a single subcutaneous injection of I-125-iothalamate. Kidney Intern. 4, 346–349.CrossRefGoogle Scholar
  41. 41.
    LaFrance, N. D., Drew, H. H., and Walser, M. (1988) Radioisotopic measurement of GFR in severe chronic renal failure. J. Nucl. Med. 29, 1927–1930.PubMedGoogle Scholar
  42. 42.
    Ham, H. R. and Piepsz, A. (1991) Estimation of GFR in infants and children using a single sample method. J. Nucl. Med. 32, 1294–1297.PubMedGoogle Scholar
  43. 43.
    Blaufox, M. D. (1989) Method for measurement of the renal blood flow, in Evaluation of Renal Function and disease with radionuclides, Blaufox, M. D. ed., Karger, Basel, pp. 84–97.Google Scholar
  44. 44.
    Russell, C. D. and Dubovsky, E. V. (1989) Measurement of renal function with radionuclides. J. Nucl. Med. 30, 2053–2057.PubMedGoogle Scholar
  45. 45.
    Blaufox, M. D., Frohmuller, H. G. W., and Campbell J. C., et al. (1963) A simplified method of estimate renal function with I-131-iodohippurate. J. Surg. Res. 3, 122–125.PubMedCrossRefGoogle Scholar
  46. 46.
    Blaufox, M. D. and Merrill, J. P. (1966) Simplified hippuran clearance measurement of renal function in man. Nephron 3, 274–281.PubMedCrossRefGoogle Scholar
  47. 47.
    Tauxe, W. H., Dubovsky, E. V., Kidd, T., et al. (1982) New formulas for the calculation of ERPF. Eur. J. Nucl. Med. 7, 51–54.PubMedGoogle Scholar
  48. 48.
    Fine, E. J., Axelrod, M., Gorkin, J., et al. (1987) Measurement of ERPF: a comparison of methods. J. Nucl. Med. 28, 1393–1400.PubMedGoogle Scholar
  49. 49.
    Eshima, D. and Taylor, A. (1991) Tc-99m MAG3: uptake on the new Tc-99m renal tubular function agent. Semin. Nucl. Med. 22, 61.CrossRefGoogle Scholar
  50. 50.
    Bubeck, B., Brandau, W., Weber, E, et al. (1990) Pharmacokinetics of Tc-99m-MAG3 in human. J. Nucl. Med. 31, 1285–1293.PubMedGoogle Scholar
  51. 51.
    Bubeck, B., Brandau, W., Weber, E, et al. (1987) The tubular extraction rate of Tc-99m-MAG3: a new quantitative parameter of renal function. Nucl. Med. Compact 18, 260–267.Google Scholar
  52. 52.
    Ozker, K, Onsel C, Kabasakal, L., et al. (1994) Tc-99m-EC. A comparative study of renal scintigraphy with Tc-99m-MAG3 and I-131-OIH in patients with obstructive renal disease. J. Nucl. Med. 35, 840–845.PubMedGoogle Scholar
  53. 53.
    Blaufox, M. D. (1989) Measurement of renal function with radioactive materials. In Evaluation of Renal Function and Disease with Radionuclides, Blaufox, M. D., ed., Karger, Basel, pp. 12–27.Google Scholar
  54. 54.
    Boer, P. (1984) Estimated lean body mass as an index for normalization of body fluid volumes in humans. Am. J. Physiol. 247, F634–F636.Google Scholar
  55. 55.
    Bubeck, B., Piepenburg, R., Grethe, U., et al. (1992) A new principle to normalize plasma concentrations allowing single-sample clearance determinations in both children and adults. Eur. J. Nucl. Med. 19, 511–516.PubMedCrossRefGoogle Scholar
  56. 56.
    Bubeck, B. (1993) Renal clearance determination with one blood sample: improved accuracy and universal applicability by a new calculation principle. Semin. Nucl. Med. 23, 73–86.PubMedCrossRefGoogle Scholar
  57. 57.
    Peipsz, A., Gordon, I., Han, K., et al. (1993) Determination of Tc-99m-MAG3 plasma clearance in children by means of a single blood sample: a multicenter study. Eur. J. Nucl. Med. 20, 244–248.Google Scholar
  58. 58.
    Russell, C. D., Taylor, A., and Eshima, D. (1989) Estimate of Tc-99m-MAG3 plasma clearance in adults from one or two blood samples. J. Nucl. Med. 30, 1955–1959.PubMedGoogle Scholar
  59. 59.
    Blaufox, M. D. (1991) Procedures of choice in renal nuclear medicine. J. Nucl. Med. 32, 1301–1309.PubMedGoogle Scholar
  60. 60.
    Taylor, A. (1998) Radionuclide renography: a personal approach. Semin. Nucl. Med. 29, 102–127.CrossRefGoogle Scholar
  61. 61.
    Stacy, B. D. and Thorburn, G. D. (1966) Cr-51-EDTA for estimate of GFR. Science 1076, 152–155.Google Scholar
  62. 62.
    Piepsz, A., Denis, R., and Ham, H. R. (1978) A simple method for measuring separate GFR using a single injection of Tc-99m-DTPA and scintillation camera. J. Pediatr. 93, 769–774.PubMedCrossRefGoogle Scholar
  63. 63.
    Gates, G. F. (1983) GFR: estimate from fractioned renal accumulation of Tc-99m-DTPA. Am. J. Roentgenol. 138, 565–570.Google Scholar
  64. 64.
    Gates, G. F. (1983) Split renal function testing using Tc-99m-DTPA: a rapid technique for determining differential glomerular filtration. Clin. Nucl. Med. 8, 400–407.PubMedCrossRefGoogle Scholar
  65. 65.
    Delpassand, E. S., Homayoon, K., Madden, T, et al. (2000) Determination of GFR using dual-detector gamma camera and the geometric mean of renal activity. Clin. Nucl. Med. 25, 258–262.PubMedCrossRefGoogle Scholar
  66. 66.
    Nielsen, S. P., Moller, M. L., and Trap-Jensen, J. (1997) Tc-99m-DTPA scintillation camera renography: a new method of estimation of single kidney function. J. Nucl. Med. 38, 112–116.Google Scholar
  67. 67.
    DeLange, M. J., Piers, D. A., Kosteerink, J. W. W., et al. (1989) Renal handling of Tc-99m-DMSA: evidence for glomerular filtration and peritubular uptake. J. Nucl. Med. 32, 766–768.Google Scholar
  68. 68.
    Yee, C. A., Lee, H. B., and Blaufox, M. D. (1981) Tc-99mDMSA renal uptake: Influence of biochemical and physiologic factors. J. Nucl. Med. 22, 1054–1058.PubMedGoogle Scholar
  69. 69.
    Groshar, D., Embon, O. M., Frenkel, A., et al. (1991) Renal function and Tc-99m-DMSA uptake in single kidney: the value of in vivo SPECT quantitation. J. Nucl. Med. 32, 766–768.PubMedGoogle Scholar
  70. 70.
    Tonnesen, K. H., Munck, O., Hold, T., et al. (1976) Influence on the radio-renogram of variation in skin to kidney distance and the clinical importance. J. Urol. 116, 282–285.Google Scholar
  71. 71.
    Peter, A. M., Bell, S. D., Gordon, I., et al. (1991) Effective background correction on separate Tc-99m-DTPA renal clearance. J. Nucl. Med. 32, 362–363.Google Scholar
  72. 72.
    Piepsz, A., Dobbeleir, A., and Ham, H. R. (1990) Effect of background correction on separate Tc-99m-DTPA renal clearance. J. Nucl. Med. 31, 430–435.PubMedGoogle Scholar
  73. 73.
    Steinmetz, A. P., Zwas, S. T., and Macadziob, S. (1998) Renal depth estimation to improve the accuracy of GFR. J. Nucl. Med. 39, 1822–1826.PubMedGoogle Scholar
  74. 74.
    Gruenwald, S. M., Collins, C. T., and Fawdry, R. M. (1985) Kidney depth measurement and its influence on quantitation of function from gamma camera renography. Clin. Nucl. Med. 10, 398–392.CrossRefGoogle Scholar
  75. 75.
    Taylor, A., Lewis, C., and Giacometti, A. (1993) Improved formulas for the estimation of renal depth in adults. J. Nucl. Med. 34, 1766–1769.PubMedGoogle Scholar
  76. 76.
    Mettler, F. A. and Guiverteau, M. J., eds. (1999) Essentials of nuclear medicine imaging, 4th ed., W. B. Saunders, Philadelphia.Google Scholar
  77. 77.
    Gonzalez, A., Puchal, R., Bajen, M. T., et. al. (1994) Tc-99m-MAG3 renogram in normal subjects and in normalfunctional kidney graft. Nucl. Med. Commun. 15, 680–684.PubMedCrossRefGoogle Scholar
  78. 78.
    Tomaru, Y., Inoue, T., Oriuchi, N., et al. (1998) Semi-automated renal region of interest selection method using the double threshold technique: inter-operator variability in quantitating Tc-99m-MAG3 renal uptake. Eur. J. Nucl. Med. 25, 55–59.PubMedCrossRefGoogle Scholar
  79. 79.
    Prigent, A., Cosgriff, P., Gates, G. F., et al. (1999) Consensus report of quality control of quantitative measurement of renal function obtained from the renogram: international consensus committee from the scientific committee of radionuclides in nephrourology. Semin. Nucl. Med. 29, 146–159.PubMedCrossRefGoogle Scholar
  80. 80.
    Thrall, J. H. and Ziessman, H. A., eds. (2001) Nuclear Medicine. The Requisites, 2nd ed, Mosby Inc., St. Louis.Google Scholar
  81. 81.
    Ramdave, S., Thomas, G. W., Salvatore, T., et al. (2001) Clinical role for F-18 FDG PET for detection and management of renal cell carcinoma. J. Urol. 166, 825–830.PubMedCrossRefGoogle Scholar
  82. 82.
    Delbeke, D. (1999) Oncological application of FDG PET imaging: brain tumors, colorectal cancer, lymphoma and melanoma. J. Nucl. Med. 40, 591.PubMedGoogle Scholar
  83. 83.
    Choi, Y., Huan, S., Hawkins, R., et al. (1993) A simplified method for the quantification of myocardial blood flow using N-13 ammonia and dynamic PET. J. Nucl. Med. 34, 488.PubMedGoogle Scholar
  84. 84.
    Raichle, M. E., Martin, W. R. W., Herscovitch, P., et al. (1983) Brain blood flow measured with intravenous H2(15)O. Implementation and validation. J. Nucl. Med. 24, 790–798.PubMedGoogle Scholar
  85. 85.
    Killion, D., Nitzsche, E., Choi, Y., et al. (1993) A new method for determination of renal function. J. Urol. 150, 1064–1068.PubMedGoogle Scholar
  86. 86.
    Juillard, L., Janier, M. F., Fouque, D., et al. (2000) Renal blood flow measurement by PET using O-15-labelled water. Kidney Int. 57, 2511–2518.PubMedCrossRefGoogle Scholar
  87. 87.
    Griendling, K. K., Murphy, T. J., and Alexander, R. W. (1993) Molecular biology of the renin-angiotensin system. Circulation 87, 1816–1828.PubMedGoogle Scholar
  88. 88.
    Bumpus, F. M., Catt, K. J., Chiu, A. T., et al. (1991) Nomenclature for angiotensin receptors. A report of the Nomenclature committee of the Council for High Blood Pressure Research. Hypertension 17, 720–721.PubMedGoogle Scholar
  89. 89.
    Bernstein, K. E. and Alexander, E. W. (1992) Counterpoint: molecular analysis of the angiotensin II receptor. Endocr. Rev. 13, 381–386.PubMedGoogle Scholar
  90. 90.
    Kim, S. E., Scheffel, U., Szabo, Z., et al. (1996) In vivo labeling of angiotensin II receptors with a carbon-11-labeled selective nonpeptide antagonist. J. Nucl. Med. 37, 307–311.PubMedGoogle Scholar
  91. 91.
    Szabo, Z., Kao, P. F., Burns, H. D., et al. (1998) Investigation of angiotensin II/AT1 receptors with carbon-11-L-159,884: A selective AT1 antagonist. J. Nucl. Med. 39, 1209–1213.PubMedGoogle Scholar
  92. 92.
    Szabo, Z., Speth, R. C., Brown, P. R., et al. (2001) Use of PET to study AT1 receptor regulation in vivo. J. Am. Soc. Nephrol. 12, 1350–1358.PubMedGoogle Scholar
  93. 93.
    Aleksic, S., Szabo, Z., Scheffel, U., et al. (2001) In vivo labeling of endothelin receptors with C-11-L-753,037: studies in mice and a dog. J. Nucl. Med. 42, 1274–1280.PubMedGoogle Scholar
  94. 94.
    Chen, B. C., Germano, G., Huan, S. C., et al. (1992) A new non-invasive quantification of renal blood flow with N-13 ammonia, dynamic PET and a two-compartmental model. J. Am. Soc. Nephrol. 3, 1295–1306.PubMedGoogle Scholar
  95. 95.
    Middlekauf, H. R., Nitzsche, E. U., Hamilton, M. A., et al. (1995) Evidence for preserved cardiopulmonary baroreflex control of renal cortical blood flow in humans with advanced heart failure. A PET study. Circulation 92, 395–401.Google Scholar
  96. 96.
    Middlehauff, H. R., Nitzsch, E. U., Nguyen, A. H., et al. (1997) Modulation of renal cortical blood flow during static exercise in humans. Circ. Res. 80, 62–68.Google Scholar
  97. 97.
    Tamaki, N., Alper, N. M., Rabito, C. A., et al. (1988) The effect of captopril on renal flow in renal artery stenosis assessed by PET with rubidum-82. Hypertension 11, 217–222.PubMedGoogle Scholar
  98. 98.
    Mullani, N. A., Ekas, R. D., Marani, S., et al. (1990) Feasibility of measuring first pass extraction and flow with rubidium-82 in the kidneys. Am. J. Physiol. Imaging 5, 133–140.PubMedGoogle Scholar
  99. 99.
    Araiyo, L., Lammertsma, A., Khodes, C., et al. (1986) Noninvasive quantification of regional myocardial blood flow in coronary artery disease with oxygen-15-labelled carbon dioxide inhalation and PET. Circulation 83, 875–885.Google Scholar
  100. 100.
    Nitzsche, E. U., Choi, Y., Killion, D., et al. (1993) Quantification and parametric imaging of renal cortical blood flow in vivo based on Patlak graphical analysis. Kidney Int. 44, 985–996.PubMedCrossRefGoogle Scholar
  101. 101.
    Kety, S. S. and Smith, S. (1960) Measurement of local blood flow by the exchange of an inert, diffusible substance. Methods Med. Res. 8, 228–236.Google Scholar

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© Humana Press Inc., Totowa, NJ 2003

Authors and Affiliations

  1. 1.Department of Nuclear MedicineMontefiore Medical CenterBronx
  2. 2.Department of Nuclear MedicineAlbert Einstein College of Medicine and Montefiore Medical CenterBronx

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