Lateral Posterior Method for Depth Correction while Using the Gates Protocol for GFR Estimation: Is it Comparable to the Gold Standard GFR Estimation by Plasma Sampling?

Glomerular filtration rate (GFR) estimation by Gates protocol using the gamma camera for diethylenetriaminepentaacetic acid (DTPA) dynamic renography has not compared well with the gold standard GFR by plasma sampling method. This is because depth of the kidneys is generally not considered. Our aim was to study whether manual depth correction using the skin to middle of kidney distance in lateral view and posterior aspect-lateral posterior method would reduce the bias in the Gates GFR as compared with the gold standard.  Retrospective study of 27 adult prospective renal donors who underwent GFR by plasma sampling and DTPA dynamic renography at Inlaks and Budhrani Hospital, Pune, Maharashtra, India between January 2022 and April 2023. The entire data was statistically analyzed using Statistical Package for Social Sciences (SPSS ver 21.0, IBM Corporation, United States) for MS Windows.  There is no significant agreement between plasma sampling versus gamma camera method and plasma sampling versus lateral posterior method for depth correction for GFR measurements; however, the evidence of systemic bias is lower for the gamma camera method compared with the lateral posterior method for depth correction as against the plasma sampling method.  The lateral posterior method for depth correction while using the gamma camera-based Gates protocol is not a reliable method for depth correction in the western Indian adult population with preserved renal function.