Glomerular filtration rate determined in conjunction with routine renal scanning.

Jackson, John H.; Blue, Peter W.; Ghaed, Nasser

doi:10.1148/radiology.154.1.3880607

Cited by 15 publications

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“…The “gold standard” for the determination of GFR has been considered to be that of continuous infusion of inulin with urine and plasma sampling; however this method is technically difficult and is rarely performed in a clinical setting. Renal DTPA clearance can be determined from: (a) Measurement of activity in single or multiple blood samples[ 6 7 8 ] (b) from the rate of removal of activity from blood or tissue[ 9 ] (c) from the rate of appearance of tracer in urine[ 10 ] and (d) from the rate of renal tracer uptake. [ 11 12 13 ]…”

Section: Discussionmentioning

confidence: 99%

“…Further, plasma clearance of Tc-99m-DTPA correlates well with inulin clearance (standardized estimation error is 3.5 ml/min). [ 10 17 ] The alternative methods used, such as DPSM and SPSM were derived from empirical analysis of the relationship between the reference GFR and the volume of distribution and plasma concentration at sample time. [ 1 18 ] Some studies have also shown that the DPSM in a mono-compartment model was proved to be more accurate in GFR determination than the SPSM.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of glomerular filtration rate measured by plasma sample technique, Cockroft Gault method and Gates′ method in voluntary kidney donors and renal transplant recipients

2013

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Background:There are numerous methods for calculation of glomerular filtration rate (GFR), which is a crucial measurement to identify patients with renal disease.Aims:The aim of this study is to compare four different methods of GFR calculation.Settings and Design:Clinical setup, prospective study.Materials and Methods:Data was collected from routine renal scans done for voluntary kidney donors (VKD) or renal transplant recipients 6 months after transplantation. Following technetium-99m diethylene triamine penta acetic acid injection, venous blood samples were collected from contralateral arm at 120, 180, and 240 min through an indwelling venous cannula and direct collection by syringe. A total volume of 1 ml of plasma from each sample and standards were counted in an automatic gamma counter for 1 min. Blood samples taken at 120 min and 240 min were used for double plasma sample method (DPSM) and a sample taken at 180 min for single plasma sample method (SPSM). Russell's formulae for SPSM and DPSM were used for GFR estimation. Gates’ method GFR was calculated by vendor provided software. Correlation analysis was performed using Pearson's correlation test.Results:SPSM correlated well with DPSM. GFR value in healthy potential kidney donors has a significant role in the selection of donors. The mean GFR ± (standard deviation) in VKD using SPSM, DPSM, camera depth method and Cockroft Gault method was 134.6 (25.9), 137.5 (42.4), 98.6 (15.9), 83.5 (21.1) respectively. Gates’ GFR calculation did not correlate well with plasma sampling method.Conclusions:Calculation of GFR plays a vital role in the management of renal patients, hence it was noted that Gates GFR may not be a reliable method of calculation. SPSM was more reliable. DPSM is reliable but cumbersome. It is difficult to accurately calculate GFR without a gold standard.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of glomerular filtration rate measured by plasma sample technique, Cockroft Gault method and Gates′ method in voluntary kidney donors and renal transplant recipients

2013

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“…The serum creatinine level was measured at 1, 3, 6 and 12 months and at the most recent follow-up visit. The graft glomerular filtration rate (GFR) was measured by technetium-99m diethylene triamine peuta-acetic acid ('l'im'fc-DTPA) scans [5] and by the determination of the endogenous creatinine clearance. Moreover, the functional reserve of the graft was assessed by the simultaneous infusion of dopamine (2.5 Jlg/kg ·min) and a 10% solution of an amino acid preparation, Yamin N (80 mllh) for 12 h. During the procedure, a diuresis of at least 100 ml/h was maintained by orally administered fluids.…”

Section: Methodsmentioning

confidence: 99%

Impact of donor age on living related donor kidney transplantation

Sobh

Yousif

Shokeir

et al. 1992

Transplant International

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Two comparable groups of kidney transplant recipients were identified according to the age of their kidney donors. The first group (A) comprised 42 recipients of donors aged < 40 years, and the second group (B) comprised 48 recipients of donors aged >50 years. The patients were followed for a mean period of 26 months (range 13-50 months). Post-transplant renal function and graft survival were assessed together with the frequency of post-transplant proteinuria and hypertension. Moreover, the functional reserve of the grafts was determined by comparing the clearance values, obtained by both isotope and chemical means, before and after a combined infusion of dopamine and an amino acids preparation. The graft function was significantly better in group A according to the serum creatinine levels (J.tmol/1) at 1 month (107 ± 4.5 vs. 134 ± 10.7, P < 0.01), 12 months (119 ± 5.3 vs. 181 ± 88, P < 0.05) and at last follow-up visit (118 ± 6.2 vs. 223 ± 63, P < 0.03) for groups A and B, respectively. The graft survival in group A was significantly higher than that in group B (100% vs. 87% at 1 year, P < 0.05). The graft functional reserve was significantly better in group A than in group B. Post-transplant proteinuria was significantly more frequent in group B recipients (70% vs. 40%, P < 0.03). The age of the donors had no impact on the incidence of post-transplant hypertension. These observations suggest that the transplantation of a kidney from an older live kidney donor is associated with an inferior post-transplant outcome.

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“…Many nuclear medicine solutions for estimating GFR using 99m Tcdiethylenetriaminepentaacetic (DTPA) are widely used today. Renal clearance can be estimated from the measurement of activity in single or multiple blood samples [2][3][4][5][6], from the rate of removal of activity from tissue or blood [7,8], from the rate of appearance of tracer in urine [9], and from the rate of renal tracer uptake. The most widely used gamma camera approach is a method introduced by Gates using approximately 3 mCi (111 MBq) of 99m Tc-DTPA and measuring the dosage in the syringe by counting it 20 cm from the face of a gamma camera before and following injection [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Fully Automatic Region of Interest Selection in Glomerular Filtration Rate Estimation from 99mTc-DTPA Renogram

Lin

Huang²,

Chen³

2011

J Digit Imaging

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Glomerular filtration rate (GFR) is a common accepted standard estimation of renal function. Gamma camera-based methods for estimating renal uptake of (99m)Tc-diethylenetriaminepentaacetic acid (DTPA) without blood or urine sampling have been widely used. Of these, the method introduced by Gates has been the most common method. Currently, most of gamma cameras are equipped with a commercial program for GFR determination, a semi-quantitative analysis by manually drawing region of interest (ROI) over each kidney. Then, the GFR value can be computed from the scintigraphic determination of (99m)Tc-DTPA uptake within the kidney automatically. Delineating the kidney area is difficult when applying a fixed threshold value. Moreover, hand-drawn ROIs are tedious, time consuming, and dependent highly on operator skill. Thus, we developed a fully automatic renal ROI estimation system based on the temporal changes in intensity counts, intensity-pair distribution image contrast enhancement method, adaptive thresholding, and morphological operations that can locate the kidney area and obtain the GFR value from a (99m)Tc-DTPA renogram. To evaluate the performance of the proposed approach, 30 clinical dynamic renograms were introduced. The fully automatic approach failed in one patient with very poor renal function. Four patients had a unilateral kidney, and the others had bilateral kidneys. The automatic contours from the remaining 54 kidneys were compared with the contours of manual drawing. The 54 kidneys were included for area error and boundary error analyses. There was high correlation between two physicians' manual contours and the contours obtained by our approach. For area error analysis, the mean true positive area overlap is 91%, the mean false negative is 13.4%, and the mean false positive is 9.3%. The boundary error is 1.6 pixels. The GFR calculated using this automatic computer-aided approach is reproducible and may be applied to help nuclear medicine physicians in clinical practice.

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Glomerular filtration rate determined in conjunction with routine renal scanning.

Cited by 15 publications

References 0 publications

Comparison of glomerular filtration rate measured by plasma sample technique, Cockroft Gault method and Gates′ method in voluntary kidney donors and renal transplant recipients

Comparison of glomerular filtration rate measured by plasma sample technique, Cockroft Gault method and Gates′ method in voluntary kidney donors and renal transplant recipients

Impact of donor age on living related donor kidney transplantation

Fully Automatic Region of Interest Selection in Glomerular Filtration Rate Estimation from 99mTc-DTPA Renogram

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