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99mTc-diethylenetriamine penta-acetate plasma clearance in advanced renal failure by the mean sojourn time approach
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
2009 (English)In: Nuclear medicine communications, ISSN 0143-3636, E-ISSN 1473-5628, Vol. 30, no 3, 202-205 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The single-sample 99mTc-diethylenetriamine penta-acetate (DTPA) clearance method by Christensen and Groth is recommended by the Radionuclides in Nephrourology Committee on Renal Clearance for use in adults with an estimated glomerular filtration rate (GFR) ≥30 ml/min. The purpose of this study was to test a new 99mTc-DTPA single-sample low clearance formula for GFR lesser than 30 ml/min.

Methods: Twenty-one adult patients (29 investigations) were included. Reference clearance was calculated with both 51Cr-EDTA and 99mTc-DTPA according to Brøchner-Mortensen with samples drawn between 3 and 24 h. Single-sample clearance was calculated from a 24 h sample using the low clearance formula

Equation (Uncited)Image Tools

C(t) is the activity of the tracer in the plasma sample t minutes after the injection and Q0 is the injected amount. ECV is the extracellular volume in ml defined as the distribution volume of the tracer. ECV is estimated from the body surface area as ECV=8116.6×body surface area-28.2.

Results: The mean difference between reference and 99mTc-DTPA single-sample clearance was -0.5 ml/min (SD 1.0 ml/min) for 99mTc-DTPA and -0.8 ml/min (SD 1.2 ml/min) for 51Cr-EDTA as reference clearance.

Conclusion: In adult patients it is possible, even with GFR lesser than 30 ml/min, to get an accurate determination of 99mTc-DTPA plasma clearance from a single sample using the mean sojourn time approach. The blood sample should be obtained about 24 h after injection of the GFR tracer.

Place, publisher, year, edition, pages
2009. Vol. 30, no 3, 202-205 p.
Keyword [en]
glomerular filtration rate, renal function, single sample, 24 h sample, 99mTc-diethylenetriamine penta-acetate clearance
URN: urn:nbn:se:umu:diva-40235DOI: 10.1097/MNM.0b013e328315e0c6OAI: diva2:398578
Available from: 2011-02-18 Created: 2011-02-18 Last updated: 2011-04-12Bibliographically approved
In thesis
1. Glomerular filtration rate in adults: a single sample plasma clearance method based on the mean sojurn time
Open this publication in new window or tab >>Glomerular filtration rate in adults: a single sample plasma clearance method based on the mean sojurn time
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Glomerular filtration rate (GFR) is a key parameter in evaluating kidney function. After a bolus injection of an exogenous GFR marker in plasma an accurate determination of GFR can be made by measuring the marker concentration in plasma during the excretion. Simplified methods have been developed to reduce the number of plasma samples needed and yet still maintain a high accuracy in the GFR determination. Groth previously developed a single sample GFR method based on the mean sojourn time of a GFR marker in its distribution volume. This method applied in adults using the marker 99m Tc-DTPA is recommended for use when GFR is estimated to be ≥ 30 mL/min. The aim of the present study was to further develop the single plasma sample GFR method by Groth including patients with severely reduced renal function and different GFR markers. Three different GFR markers 51Cr-EDTA, 99mTc-DTPA and iohexol were investigated. Formulas were derived for the markers 51Cr-EDTA and iohexol when GFR is estimated to be ≥ 30 mL/min. For patients with an estimated GFR < 30 mL/min a special low clearance formula with a single sample obtained about 24 h after marker injection was developed. The low clearance formula was proven valid for use with all three markers. The sources of errors and their influence on the calculated single sample clearance were investigated. The estimated distribution volume is the major source of error but its influence can be reduced by choosing a suitable sampling time. The optimal time depends on the level of GFR; the lower GFR the later the single sample should be obtained. For practical purpose a 270 min sample is recommended when estimated GFR ≥ 30 mL/min and a 24 h sample when estimated GFR < 30 mL/min. Sampling at 180 min after marker injection may be considered if GFR is estimated to be essentially normal.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 53 p.
, Licentiatuppsats, Klinisk fysiologi
Research subject
Clinical Physiology
urn:nbn:se:umu:diva-42319 (URN)978-91-7459-158-3 (ISBN)
2011-05-12, Biblioteket, Enheten för klinisk fysiologi, våning 1, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Available from: 2011-04-12 Created: 2011-04-07 Last updated: 2011-04-12Bibliographically approved

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