Measurement of Glomerular FiltrationRate by the &lt;sup&gt;99m&lt;/sup&gt;&lt; /sup&gt;Tc-DTPA Renogram Is Less Precise than Measured and Predicted Creatinine Clearance

Santo, Natale G. De; Anastasio, P; Cirillo, Massimo; Santoro, Domenico; Spitali, L; Mansi, Luigi; Celentano, Luigi; Capodicasa, D.; Cirillo, Eleonora; Vecchio, E. Del; Pascale, C. De; Capasso, Giovambattista

doi:10.1159/000045268

Cited by 55 publications

(45 citation statements)

References 8 publications

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“…Nevertheless, Assadi et al revealed that the Gates' method has a good correlation with the plasma sample method and was more precise than the CG method (37). Our results are consistent with previous results (35). We found a strong correlation between the TPS method and Gates' methods in our study.…”

Section: Discussionsupporting

confidence: 93%

Comparison of glomerular filtration rate measurements with the two-plasma sample technique using Tc-99m DTPA and other methods in donor candidates for renal transplantation

et al. 2016

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Background/aim: Accurate measurement of glomerular filtration rate (GFR) in the evaluation of renal functions in potential kidney donors is associated with important outcomes for both the donor and recipient. We intended to determine the efficacy of various methods while estimating GFR in potential living kidney donors.Materials and methods: Fifty-three potential kidney donors (31 females, 22 males; mean age: 50.1 years) were included in this study. GFR was estimated simultaneously using the following methods: Gates' method, Cockcroft-Gault (CG) and modification of diet in renal disease (MDRD) prediction equations, and the two-plasma sample (TPS) technique. Using TPS as the reference method, the estimations of GFR with the other methods were compared with that of TPS.

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Section: Discussionsupporting

confidence: 93%

Comparison of glomerular filtration rate measurements with the two-plasma sample technique using Tc-99m DTPA and other methods in donor candidates for renal transplantation

et al. 2016

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“…This discrepancy may be due to the use of serum creatinine for the calculation of creatinine clearance. Although creatinine clearance was shown to be a more precise method for the estimation of GFR as compared with 99m Tc-DTPA clearance [28], it is an indirect measurement of renal function and has its limitations which have been discussed elsewhere [29]. Therefore, the missed difference in the ROC analysis of the total study group may be due to this putative bias.…”

Section: Discussionmentioning

confidence: 99%

Cystatin C as an Endogenous Marker of Glomerular Filtration Rate in Renal Transplant Patients

Pöge¹,

Stoschus²,

Stoffel‐Wagner

et al. 2003

Kidney Blood Press Res

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Background: Serum creatinine is the most common endogenous marker used to estimate the glomerular filtration rate (GFR). However, creatinine depends considerably on muscle mass, and its tubular secretion increases, especially in chronic renal failure. Cystatin C is a 13-kD protease inhibitor which is produced by all nucleated cells and is independent of muscle mass and sex. Cystatin C is eliminated by glomerular filtration and metabolized by proximal tubular cells. Its measurement has been proposed as an alternative and more sensitive marker of GFR than creatinine in patients with slight to moderately decreased GFR. Methods: We investigated serum cystatin C levels in comparison with creatinine as a single measurement for estimation of GFR in 173 patients after renal transplantation. GFR was calculated as creatinine clearance according to standard equations. Results: Serum creatinine correlated well with cystatin C (r = 0.84; p < 0.0001). No significant differences were obtained for the comparison of the linear correlation of 1/creatinine with creatinine clearance (r = 0.77; p < 0.0001) and for the linear correlation of 1/cystatin C with creatinine clearance (r = 0.73; p < 0.0001). However, we found a significant advantage of cystatin C in detecting a clinical relevant reduction of kidney function (GFR <70 ml/min; p = 0.0047, McNemar test). Conclusion: Cystatin C is an alternative marker for the assessment of GFR in renal allograft recipients that may be superior to creatinine.

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“…Although the diagnostic accuracy of these methods is debated, they are regarded as convenient and less invasive, and can also be used to evaluate the function of each kidney individually [8,9]. However, a simple and accurate determination of GFR is still a clinical challenge [10].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2008

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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 plasmaclearance 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.

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Measurement of Glomerular FiltrationRate by the <sup>99m</sup>< /sup>Tc-DTPA Renogram Is Less Precise than Measured and Predicted Creatinine Clearance

Cited by 55 publications

References 8 publications

Comparison of glomerular filtration rate measurements with the two-plasma sample technique using Tc-99m DTPA and other methods in donor candidates for renal transplantation

Comparison of glomerular filtration rate measurements with the two-plasma sample technique using Tc-99m DTPA and other methods in donor candidates for renal transplantation

Cystatin C as an Endogenous Marker of Glomerular Filtration Rate in Renal Transplant Patients

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

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