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KMID : 1143620210250020035
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Korean Journal of Nuclear Medicine Technology
2021 Volume.25 No. 2 p.35 ~ p.40
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Comparative analysis of Glomerular Filtration Rate measurement and estimated glomerular filtration rate using 99mTc-DTPA in kidney transplant donors
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Cheon Jun-Hong
Yoo Nam-Ho
Lee Sun-Ho
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Abstract
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Purpose: Glomerular filtration rate(GFR) is an important indicator for the diagnosis, treatment, and follow-up of kidney disease and is also used by healthy individuals for drug use and evaluating kidney function in donors. The gold standard method of the GFR test is to measure by continuously injecting the inulin which is extrinsic marker, but it takes a long time and the test method is complicated. so, the method of measuring the serum concentration of creatinine is used. Estimated glomerular filtration rate (eGFR) is used instead. However, creatinine is known to be affected by age, gender, muscle mass, etc. eGFR formulas that are currently used include the Cockroft-Gault formula, the modification of diet in renal disease (MDRD) formula, and the chronic kidney disease epidemilogy collaboration (CKD-EPI) formula for adults. For children, the Schwartz formula is used. Measurement of GFR using 51Cr-EDTA (diethylenetriamine tetraacetic acid), 99mTc-DTPA (diethylenetriamine pentaacetic acid) can replace inulin and is currently in use. Therefore, We compared the GFR measured using 99mTc-DTPA with the eGFR using CKD-EPI formula.
Materials and Methods: For 200 kidney transplant donors who visited Asan medical center.(96 males, 104 females, 47.3 years ± 12.7 years old) GFR was measured using plasma(Two-plasma-sample-method, TPSM) obtained by intravenous administration of 99mTc-DTPA(0.5mCi, 18.5 MBq). eGFR was derived using CKD-EPI formula based on serum creatinine concentration.
Results: GFR average measured using 99mTc-DTPA for 200 kidney transplant donors is 97.27±19.46(ml/min/1.73m2), and the eGFR average value using the CKD-EPI formula is 96.84±17.74(ml/min/1.73m2), The concentration of serum creatinine is 0.84±0.39(mg/dL). Regression formula of 99mTc-DTPA GFR for serum creatinine-based eGFR was Y = 0.5073X + 48.186, and the correlation coefficient was 0.698 (P<0.01). Difference (%) was 1.52±18.28.
Conclusion: The correlation coefficient between the 99mTc-DTPA and the eGFR derived on serum creatinine concentration was confirmed to be moderate. This is estimated that eGFR is affected by external factors such as age, gender, and muscle mass and use of formulas made for kidney disease patients. By using 99mTc-DTPA, we can provide reliable GFR results, which is used for diagnosis, treatment and observation of kidney disease, and kidney evaluation of kidney transplant patients.
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KEYWORD
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GFR, 99mTc-DTPA, eGFR
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