Assessment of individual renal function in children using 99mTc-DTPA.

Abstract

SUMMARY Differential renal function assessment using s9mTc-DTPA was carried out in 12 children aged between 3 weeks and 11 years who had undergone surgical procedures which allowed separate access to the urine output from each kidney. The results correlated well with those obtained by measuring individual kidney creatinine clearances. The best result was obtained using the technique of deconvolution analysis (r 0.98; P<0O 001). We conclude that the method is accurate and recommend its use in the management and follow-up of patients with asymmetric renal disease.The need for a reliable noninvasive method for studying individual kidney function in children is apparent. The damage incurred by the kidneys in diseases such as vesicoureteric reflux and obstructive uropathy is seldom symmetrical, and the selection of optimal treatment and follow-up requires quantitative information about the functional status of each kidney as well as knowledge of the total renal function. An example of the type of case in which such information would be useful is that of a child with bilateral reflux nephropathy who has poor function of one kidney on intravenous urography. A decision has to be made as to whether ureteric reimplantation or nephrectomy should be carried out. It would obviously be advantageous if the relative function of the affected kidney could accurately be assessed.Radiographic contrast techniques give valuable information about the anatomical structure of the kidneys and collecting systems. However, they provide only qualitative information on differential renal function. Bilateral ureteric cannulation for the measurement of individual kidney clearances carries the risk of introducing infection and requires general anaesthesia, and is therefore not suitable for routine use.

Motion‐compensated image reconstruction for improved kidney function assessment using dynamic contrast‐enhanced MRI

“…Clinicians rely on glomerular filtration rate (GFR) and differential renal function (DRF) as gold standard clinical markers to evaluate renal function. However, traditional methods for measuring kidney function such as serum creatinine‐based estimated GFR (i.e., eGFR) fail to detect early decline, 4 while nuclear medicine‐based GFR takes over four hours and exposes the patient to radiation 5 . A more efficient and safer method for renal function assessment is dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI), which combines quantitative renal function assessment and anatomical imaging with superior resolution in less time (6–8 minutes) without radiation exposure 6 .…”

How Measuring Glomerular Filtration Rate? Comparison of Reference Methods

“…DTPA may be labeled with another isotopic marker ( 113m Indium (Johansson & Falch, 1978;Reba et al, 1968;Piepsz et al, 1974), 169 Ytterbium (Perrone et al, 1990;Russell et al, 1985)) but technetium 99 is the most used up to now. The 99 Tc-DTPA is also used in Nuclear Imagery (isotopic nephrogram) for instance to measure separately the function or the right and left kidney (Biggi et al, 1995;Hilson et al, 1976;Kainer et al, 1979). However, we will only discuss GFR measurement based on plasma and/or urinary methods with 99 Tc-DTPA.…”