Title: Comparison between GFR Values Obtained by CG-formula and DTPA Renography in Different Renal Disorders
Authors: Dr V. Sivasubramaniyan, Mr Sai Shiv Narayan, Prof K. Venkataramaniah
DOI: http://dx.doi.org/10.18535/jmscr/v4i6.52
Aim: The present study aims at comparing the glomerular filtration rate (GFR) values obtained by using Cockcroft-Gault (CG) formula and DTPA renography in different renal disorders. Material and method: This retrospective study consists of 50 patients diagnosed with renal disorders. Out of 50 patients, 25 were males (50%) in the age range of 7 to 60 with the mean age of 31±16 and remaining 25 were females (50%) in the same age range with the mean age of 34±14 refered to us for various renal disorders. Renal scans were done using Siemens dual head gamma camera (E.CAM). The radio pharmaceutical 99m Tc-DTPA was used and injected intravenously. The dose used for the adults was in the range of 3 to 5 mCi (111 to 185 MBq) and the dose used for the children was in the range of 1 to 3 mCi (37 to 111 MBq), the images were processed by using GFR/Renal differetial processing protocol in icon software. Result: The mean total GFR by DTPA Gates method was 71.3 ± 20.8 ml/min and by the Cockroft Gault (CG) method was 73 ± 20.2 ml/min. The difference was statistically insignificant indicating an agreement between both the methods in measuring GFR. Conclusion: The results of the present study suggests that the Gates method used in DTPA renography provides almost equal estimation of GFR in patients with different renal disorders when compared to CG method. Key words: 99m Tc–DTPA Renography, Gamma camera, GFR, CG formula. 1. Julie Hephzibah, Regi Oommen, Nylla Shanthly. Comparison of glomerular filtration rate measured by plasma sample technique, Cockroft Gault method and Gates' method in voluntary kidney donors and renal transplant recipients. Indian J Nucl Med. 2013 Jul-Sep; 28(3): 144–151. 2. Glomerular Filtration Rate: Estimation from Fractional Renal Accumulation of 99mTc-DTPA. Review paper. 3. Gopal Sonai Muthu, Sujata Mitra. Improved Quantification of Glomerular Filtration Rate and Differential Renal Function of Ectopic Kidneys in a Dual Head Gamma Camera. Open Journal of Medical Imaging, 2014; 4, 14-227. 4. Yong-il Kim, Seunggyun Ha, Young So, Won Woo Lee, Seok-Soo Byun, and Sang Eun Kim. Improved measurement of the glomerular filtration rate from Tc-99m DTPA scintigraphy in patients following nephrectomy. Eur Radiol. 2014; 24: 413–422. 5. Majid Asadi et al. 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. In Urol Nephrol 2008; 40:1059–65. 6. Peterson LJ, Petersen JR, Talleruphuus U, Moller TA, Ladefoged SD, Mehlsen J, et al. Glomerular filtration rate estimated from the uptake phase of 99mTc-DTPA renography in chronic renal failure. Nephron Dial Transplant. 1999; 14:1673–8. 7. Séronie-Vivien S, Galteau MM, Carlier MC, Hadj-Aissa A, Hanser AM, Hym B, et al. Impact of standardized calibration on the inter‑assay variation of 14 automated assays for the measurement of creatinine in human serum. Clin Chem Lab Med. 2005; 43:1227-33. 8. Bostom AG, Kronenberg F, Ritz E. Predictive performance of renal function equations for patients with chronic kidney disease and normal serum creatinine levels. J Am Soc Nephrol. 2002; 13:2140-4. 9. Rehling M, Møller ML, Thamdrup B, Lund JO, Trap-Jensen J. Simultaneous measurement of renal clearance and plasma clearance of 99mTc-labelled diethylene-triaminepenta-acetate, 51Cr‑labelled ethylenediaminetetra‑acetate and inulin in man. Clin Sci (Lond). 1984; 66:613-9. 10. Perrone RD, Steinman TI, Beck GJ, Skibinski CI, Royal HD, Lawlor M, et al. Utility of radioisotopic filtration markers in chronic renal insufficiency: Simultaneous comparison of 125I-iothalamate, 169Yb-DTPA, 99mTc-DTPA, and inulin. The Modification of Diet in Renal Disease Study. Am J Kidney Dis. 1990; 16:224-35. 11. N. Prasad, S. Barai1, S. Gambhir1, D. S. Parasar1, M. Ora1, A. Gupta, R. K. Sharma. Comparison of glomerular filtration rate estimated by plasma clearance method with modification of diet in renal disease prediction equation and Gates method. Indian Journal of Nephrology. March-April, 2012; Vol. 22, No. 2, pp. 103-107. 12. Russell CD, Bischoff PG, Rowell KL, Kontzen F, Lloyd LK, et al. Quality control of Tc-99m DTPA for measurement of glomerular filtration: concise communi-cation. J Nucl Med. 1983; 24: 722–727. 13. Zhao WY, Zeng L, Zhu YH, Wang LM, Zhou MS, et al. A comparison of prediction equations for estimating glomerular filtration rate in Chinese potential living kidney donors. Clin Transplant. 2009; 23: 469–475. 14. Srinivas S, Annigeri RA, Mani MK, Rao BS, Kowdle PC, et al. Estimation of glomerular filtration rate in South Asian healthy adult kidney donors. Nephrology (Carlton). 2008; 13: 440–446. 15. Poge U, Gerhardt T, Stoffel-Wagner B, Sauerbruch T, Woitas RP Validation of the CKD-EPI formula in patients after renal transplantation. Nephrol Dial Transplant. 2011; 26: 4104–4108.Abstract
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