Department of Geriatric Medicine, School of Medicine, Ankara University, Ankara, Turkey.
Ren Fail. 2012;34(4):435-41. doi: 10.3109/0886022X.2011.654168. Epub 2012 Jan 24.
Technetium-99m diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) is an ideal radioisotopic method having a high correlation with inulin clearance for the determination of glomerular filtration rate (GFR). Different formulas like creatinine clearance (CrCl) in 24 h urine samples, Cockroft-Gault formula (CGF), and modification of diet in renal disease (MDRD) are being used to come up with an estimate. In this study, we compared (99m)Tc-DTPA with the formulas mentioned above in an attempt to best identify the method that would yield the nearly ideal GFR estimates in the elderly.
In 76 patients who were admitted to our clinic, we measured 24 h urine volume (V), urine creatinine (Ucr), and serum creatinine (Scr) levels together with CrCl, Scr, serum urea (Su), and albumin (Alb) levels. By using coefficients identified for age, gender, and race, we calculated modification of diet in renal disease 1 (MDRD1). Different from MDRD1, we calculated modification of diet in renal disease 2 (MDRD2) that does not include Su and Alb parameters and formulas like CGF that include Scr, age, gender, and weight parameters to come up with GFR levels. All patients underwent (99m)Tc-DTPA procedure.
The mean of the GFR values measured by (99m)Tc-DTPA was 54.3 ± 19.9. The means of GFR values calculated by CrCl, MDRD1, MDRD2, and CGF were 58.0 ± 30.5, 60.9 ± 22.1, 54.4 ± 20.1, and 57.9 ± 22.4, respectively. GFR as measured by (99m)Tc-DTPA showed statistically significant correlations with the results of other methods (p < 0.001 for all methods). The most significant correlation was with MDRD1.
MDRD1 can be used for next to ideal and accurate predictions of GFR in the elderly in the daily practice.
锝-99m 二乙三胺五乙酸（(99m)Tc-DTPA）是一种理想的放射性同位素方法，与菊粉清除率高度相关，可用于测定肾小球滤过率（GFR）。目前，人们使用不同的公式，如 24 小时尿液样本中的肌酐清除率（CrCl）、 Cockroft-Gault 公式（CGF）和肾脏病饮食改良公式（MDRD），来进行估算。在这项研究中，我们将 (99m)Tc-DTPA 与上述公式进行了比较，试图找到最适合评估老年人近乎理想 GFR 的方法。
我们对 76 名就诊于我院的患者同时检测了 24 小时尿量（V）、尿肌酐（Ucr）和血清肌酐（Scr）水平，以及 CrCl、Scr、血清尿素（Su）和白蛋白（Alb）水平。通过对年龄、性别和种族进行校正，我们计算了肾脏病饮食改良公式 1（MDRD1）。与 MDRD1 不同，我们计算了肾脏病饮食改良公式 2（MDRD2），它不包括 Su 和 Alb 参数，还包括了 CGF 公式中的 Scr、年龄、性别和体重参数，以计算 GFR 水平。所有患者均接受了 (99m)Tc-DTPA 检测。
(99m)Tc-DTPA 检测的 GFR 值平均为 54.3±19.9。CrCl、MDRD1、MDRD2 和 CGF 计算的 GFR 值平均值分别为 58.0±30.5、60.9±22.1、54.4±20.1 和 57.9±22.4。(99m)Tc-DTPA 检测的 GFR 值与其他方法的结果均呈显著统计学相关（所有方法 p<0.001）。与 MDRD1 的相关性最为显著。
MDRD1 可用于日常实践中对老年人 GFR 进行近乎理想和准确的预测。
