ESTIMATION OF GLOMERULAR FILTRATION RATE BY USING TC-99M DTPA PLASMA 1 SAMPLE METHOD, GATES METHOD, COCKCROFT-GAULT METHOD AND PREDICTED CREATININE CLEARANCE METHOD: A PROSPECTIVE COMPARATIVE ANALYSIS WITH PLASMA 2 - SAMPLE CLEARANCE METHOD

Nosheen Fatima, Maseeh Uz Zaman, Khalid Niaz, Salman Habib, Sharjeel Usmani, Shahid Kamal, Abid Hameed
2015 Journal of the Dow University of Health Sciences  
Study Objective: To compare diagnostic accuracy of predicted clearance method, Gates method, Cockcroft-Gault method and plasma 1- sample clearance method with plasma 2-samples clearance method with Tc-99m DTPA for the estimation of glomerular filtration rate(GFR).Study Design: Comparative study. Materials and Methods: This study included 91 consecutive patients who were referred for evaluation ofrenal function to the Nuclear Medicine section of Karachi Institute of Radiotherapy and Nuclear
more » ... ine(KIRAN) from September 2004 to September 2005. The GFR was determined simultaneously by 5 methodsincluding Plasma two-Sample Clearance method after Tc-99m DTPA injection (PSC 2); Plasma one-SampleClearance method after Tc-99 m DTPA injection (PSC 1); Gamma camera uptake method after Tc-99mDTPA injection (Gates method); Predicted Creatinine Clearance by Modification of Diet and Renal Diseases(MDRD); and Cockcroft-Gault's equation for GFR estimation (CG). PSC 2 was chosen as a reference. Results: Out of the 91 patients, 71 were males and 20 females with age ranging from 16-68 years. Theregression equation of the PSC 1, Gates, MDRD and CG method against the PSC 2 was Y = 1.884 +0.970X(r=0.90, p<0.001, SEE value=10.23 ml/min/1.73m2), Y = - 9.944 + 1.083X (r=0.82, p<0.001, SEE value=11.02ml/min/1.73m2), Y =25.606+ 0.640X (r=0.71, p=0.002, SEE value=15.56 ml/min/1.73m2), and Y =14.981+0.714X (r=0.77, p=0.002, SEE value=14.44 ml/min/1.73m2) respectively. In comparison with the GFR byPSC 2, the PSC 1 and Gates tended to overestimate by 1% (p=0.359) and 2% (p=0.265) respectively, MDRDand CG tended to underestimate GFR by 11% and 14% respectively (p<0.001). Conclusions: PSC 1 correlate well with PSC 2 and either can be substituted for the other as ideal GFRmarkers. The Gates method shows good correlation with PSC 2 however it is less precise than PSC 1. MDRDand CG methods due to significant underestimation are not considered as ideal GFR marker.
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