1. Comparison of 51 Cr-EDTA and 99m Tc-DTPA for glomerular filtration rate measurement.
- Author
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Vidal-Petiot E, Courbebaisse M, Livrozet M, Corrégé G, Rusu T, Montravers F, Baron S, Dupont L, Balouzet C, Smadja C, Leygnac S, Pariscoat G, Rose J, Rouzet F, Houillier P, Haymann JP, and Flamant M
- Subjects
- Edetic Acid, Glomerular Filtration Rate, Humans, Male, Middle Aged, Prospective Studies, Technetium, Technetium Tc 99m Pentetate
- Abstract
Purpose: The production of
51 Cr-labelled ethylenediaminetetraacetic acid (51 Cr-EDTA), a validated and widely used radio-isotopic tracer for glomerular filtration rate (GFR) measurement in Europe, was recently halted by the manufacturer. Technetium-99m-diethylenetriaminepentaacetic acid (99m Tc-DTPA) clearance has so far mostly been restricted to assessment of separate renal function by scintigraphy, but scarcely used and validated for GFR measurement. We compared the performances of51 Cr-EDTA and99m Tc-DTPA for GFR and extracellular fluid measurement., Methods: In a multi-centre prospective study,51 Cr-EDTA and99m Tc-DTPA were simultaneously injected into 88 patients, and their urinary and plasma clearances, as well as their volumes of distribution, were measured during seven 30-min periods after a 90-min equilibrium time., Results: Mean age was 52.2 ± 14.5 years, 59% were men. Urinary clearances of51 Cr-EDTA and99m Tc-DTPA were 64.1 ± 27.6 and 66.1 ± 28.0 mL/min, respectively, with a mean bias of 2.00 ± 2.25 mL/min, an accuracy within 10% of 95% [95% CI 91-99], and a coefficient of determination (R2 ) of 0.994. Plasma clearances of51 Cr-EDTA and99m Tc-DTPA were 66.1 ± 25.8 and 68.1 ± 26.6 mL/min, respectively, with a mean bias of 1.96 ± 3.32 mL/min, an accuracy within 10% of 91% [95% CI 85-97] and a R2 of 0.985. Distribution volumes were 17.3 ± 4.6 L for51 Cr-EDTA and 16.6 ± 4.6 L for99m Tc-DTPA (R2 0.930)., Conclusion: The accuracy and precision of99m Tc-DTPA clearance, compared to51 Cr-EDTA clearance, was excellent for both urinary and plasma clearance methods, despite an approximate 2 mL/min overestimation, showing that the tracer is a reliable alternative to51 Cr-EDTA for GFR measurement.- Published
- 2021
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