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Comparison of methods for determination of glomerular filtration rate: low and high-dose Tc-99m-DTPA renography, predicted creatinine clearance method, and plasma sample method.
Int Urol Nephrol. 2008; 40(4):1059-65.IU

Abstract

The gamma camera uptake method with Tc-99m-DTPA (diethylenetriaminepentaacetic acid) is a simple method for determination of glomerular filtration rate (GFR), and is less time-consuming than other methods, but its diagnostic accuracy is debated. Gate's method (low-dose; LD), the high-dose method (HD), the predicted-clearance method, and the plasma-clearance method with Tc-99m-DTPA are compared in this study. We also performed GFR measurement and diuretic renography simultaneously. Tc-99m DTPA renography was performed in 36 patients aged 18-72 years with a wide range of renal function (serum creatinine 1.37 +/- 0.49 mg/dl). GFR was determined by four methods: the gamma camera uptake method with low-dose Tc-99m DTPA (Gates, LD); the gamma camera uptake method with high-dose Tc-99m DTPA (HD); the predicted creatinine clearance method (Cockcroft-Gualt, CG); and the plasma sample clearance (PSC) method using a mono-exponential curve. The PSC method was chosen as reference. The regression equations for the CG, Gates (low-dose), and HD methods against the PSC method were 28.68 + 0.80X (r = 0.72; P value < 0.0001, RMSE = 21.65 ml/min/1.73 m(2)), 6.19 + 0.79X (r = 0.90; P value < 0.0001, RMSE = 10.64 ml/min/1.73 m(2)), and 6.53 + 0.88X (r = 0.93; P value < 0.0001, RMSE = 9.35 ml/min/1.73 m(2)), respectively. In comparison with determination of GFR by the PSC method, the CG method tended to overestimate GFR while, perversely, the LD and HD methods tended to underestimate GFR. The three methods were in agreement with the PSC method but the high-dose GFR method resulted in less error in estimation of GFR. Furthermore, GFR measurement and diuretic renography could be performed at the same time when the high-dose method was used. Because of the low cost and negligible radiation burden, this method might be preferred for routine practice in nuclear medicine.

Authors+Show Affiliations

Department of Oncology and Nuclear Medicine, The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Boostan 19 Alley, 7514763448, imam Khomeini Street, Bushehr, Iran. assadipoya@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18690545

Citation

Assadi, Majid, et al. "Comparison of Methods for Determination of Glomerular Filtration Rate: Low and High-dose Tc-99m-DTPA Renography, Predicted Creatinine Clearance Method, and Plasma Sample Method." International Urology and Nephrology, vol. 40, no. 4, 2008, pp. 1059-65.
Assadi M, Eftekhari M, Hozhabrosadati M, et al. Comparison of methods for determination of glomerular filtration rate: low and high-dose Tc-99m-DTPA renography, predicted creatinine clearance method, and plasma sample method. Int Urol Nephrol. 2008;40(4):1059-65.
Assadi, M., Eftekhari, M., Hozhabrosadati, M., Saghari, M., Ebrahimi, A., Nabipour, I., Abbasi, M. Z., Moshtaghi, D., Abbaszadeh, M., & Assadi, S. (2008). Comparison of methods for determination of glomerular filtration rate: low and high-dose Tc-99m-DTPA renography, predicted creatinine clearance method, and plasma sample method. International Urology and Nephrology, 40(4), 1059-65. https://doi.org/10.1007/s11255-008-9446-4
Assadi M, et al. Comparison of Methods for Determination of Glomerular Filtration Rate: Low and High-dose Tc-99m-DTPA Renography, Predicted Creatinine Clearance Method, and Plasma Sample Method. Int Urol Nephrol. 2008;40(4):1059-65. PubMed PMID: 18690545.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of methods for determination of glomerular filtration rate: low and high-dose Tc-99m-DTPA renography, predicted creatinine clearance method, and plasma sample method. AU - Assadi,Majid, AU - Eftekhari,Mohammad, AU - Hozhabrosadati,Mehrdad, AU - Saghari,Mohsen, AU - Ebrahimi,Abdolali, AU - Nabipour,Iraj, AU - Abbasi,Mohammad Zaki, AU - Moshtaghi,Darab, AU - Abbaszadeh,Moloud, AU - Assadi,Sakineh, Y1 - 2008/08/09/ PY - 2008/01/10/received PY - 2008/07/23/accepted PY - 2008/8/12/pubmed PY - 2009/3/4/medline PY - 2008/8/12/entrez SP - 1059 EP - 65 JF - International urology and nephrology JO - Int Urol Nephrol VL - 40 IS - 4 N2 - The gamma camera uptake method with Tc-99m-DTPA (diethylenetriaminepentaacetic acid) is a simple method for determination of glomerular filtration rate (GFR), and is less time-consuming than other methods, but its diagnostic accuracy is debated. Gate's method (low-dose; LD), the high-dose method (HD), the predicted-clearance method, and the plasma-clearance method with Tc-99m-DTPA are compared in this study. We also performed GFR measurement and diuretic renography simultaneously. Tc-99m DTPA renography was performed in 36 patients aged 18-72 years with a wide range of renal function (serum creatinine 1.37 +/- 0.49 mg/dl). GFR was determined by four methods: the gamma camera uptake method with low-dose Tc-99m DTPA (Gates, LD); the gamma camera uptake method with high-dose Tc-99m DTPA (HD); the predicted creatinine clearance method (Cockcroft-Gualt, CG); and the plasma sample clearance (PSC) method using a mono-exponential curve. The PSC method was chosen as reference. The regression equations for the CG, Gates (low-dose), and HD methods against the PSC method were 28.68 + 0.80X (r = 0.72; P value < 0.0001, RMSE = 21.65 ml/min/1.73 m(2)), 6.19 + 0.79X (r = 0.90; P value < 0.0001, RMSE = 10.64 ml/min/1.73 m(2)), and 6.53 + 0.88X (r = 0.93; P value < 0.0001, RMSE = 9.35 ml/min/1.73 m(2)), respectively. In comparison with determination of GFR by the PSC method, the CG method tended to overestimate GFR while, perversely, the LD and HD methods tended to underestimate GFR. The three methods were in agreement with the PSC method but the high-dose GFR method resulted in less error in estimation of GFR. Furthermore, GFR measurement and diuretic renography could be performed at the same time when the high-dose method was used. Because of the low cost and negligible radiation burden, this method might be preferred for routine practice in nuclear medicine. SN - 0301-1623 UR - https://www.unboundmedicine.com/medline/citation/18690545/Comparison_of_methods_for_determination_of_glomerular_filtration_rate:_low_and_high_dose_Tc_99m_DTPA_renography_predicted_creatinine_clearance_method_and_plasma_sample_method_ L2 - https://doi.org/10.1007/s11255-008-9446-4 DB - PRIME DP - Unbound Medicine ER -