Browse > Article
http://dx.doi.org/10.3339/jkspn.2013.17.2.57

Glomerular Filtration Rate Measurements Using $^{99m}$Technetium-mercaptoacetyltriglycine Dynamic Renal Scintigraphy in Children with Renal Disease  

Yoon, In Ae (Department of Pediatrics, College of Medicine, Chung-Ang University)
Yun, Ki Wook (Department of Pediatrics, College of Medicine, Chung-Ang University)
Lim, In Seok (Department of Pediatrics, College of Medicine, Chung-Ang University)
Choi, Eung Sang (Department of Pediatrics, College of Medicine, Chung-Ang University)
Yoo, Byung Hun (Department of Pediatrics, College of Medicine, Chung-Ang University)
Publication Information
Childhood Kidney Diseases / v.17, no.2, 2013 , pp. 57-64 More about this Journal
Abstract
Purpose: In children, 24-hour urine collections are unreliable for evaluating glomerular filtration rate (GFR) because of the difficulty of regulating voiding and the daily variation of urinary creatinine up to 25%. Additionally, creatinine clearance (Ccr) based on urinary creatinine is considered inaccurate. The purpose of this study was to compare estimated GFR determined using Ccr, formulas with serum cystatin C and creatinine, and $^{99m}Tc$-mercaptoacetyltriglycine (MAG3) dynamic renal scintigraphy. Methods: This retrospective study included 101 patients (age, <18 years) who visited Chung-Ang University Hospital between July 2011 and August 2012. GFR was estimated using 24-hour urinary creatinine, five formulas with serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan. Results: Of the 101 patients, glomerular renal diseases were present in 60 patients (59.4%) and non-glomerular diseases were present in 41 patients (40.6%). There was a significant correlation between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and Ccr (r=0.389, P <0.001). The correlation values between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and each formula of Schwartz, Counahan-Barratt, Cockcroft-Gault, Filler and Lepage, and Bokencamp were 0.265 (P=0.007), 0.128 (P=0.044), 0.230 (P=0.021), 0.356 (P<0.001), and 0.355 (P <0.001), respectively. $^{99m}Tc$-MAG3 renal scan was correlated with estimated-GFR by all formulas in decreased renal function. Conclusion: Estimated GFRs determined using serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan correlated well with estimated GFR determined using Ccr. $^{99m}Tc$-MAG3 renal scan may be replaced for evaluation of renal function with convenience in patients with renal disease and decreased renal function in childhood.
Keywords
Glomerular filtration rate; Creatinine clearance; $^{99m}Tc$-MAG3 renal scintigraphy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatric clinics of North America 1987;34:571-90.   DOI
2 Rule AD, Gussak HM, Pond GR, Bergstralh EJ, Stegall MD, Cosio FG, Larson TS. Measured and estimated GFR in healthy potential kidney donors. American journal of kidney diseases : the official journal of the National Kidney Foundation 2004;43: 112-9.   DOI
3 Hoek FJ, Kemperman FA, Krediet RT. A comparison between cystatin C, plasma creatinine and the Cockcroft and Gault formula for the estimation of glomerular filtration rate. Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2003;18:2024-31.   DOI
4 Itoh K. 99mTc-MAG3: review of pharmacokinetics, clinical application to renal diseases and quantification of renal function. Annals of nuclear medicine 2001;15:179-90.   DOI
5 Andersen TB, Jodal L, Erlandsen EJ, Morsing A, Frokiaer J, Brochner-Mortensen J. Detecting reduced renal function in children: comparison of GFR-models and serum markers. Pediatric nephrology 2013;28:83-92.   DOI
6 Stevens LA, Stoycheff N. Standardization of serum creatinine and estimated GFR in the Kidney Early Evaluation Program (KEEP). American journal of kidney diseases : the official journal of the National Kidney Foundation 2008;51(4 Suppl 2):S77-82.   DOI
7 Grubb A, Nyman U, Bjork J, Lindstrom V, Rippe B, Sterner G, Christensson A. Simple cystatin C-based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the Counahan-Barratt prediction equations for children. Clinical chemistry 2005;51: 1420-31.   DOI
8 Sharma AP, Yasin A, Garg AX, Filler G. Diagnostic accuracy of cystatin C-based eGFR equations at different GFR levels in children. Clinical journal of the American Society of Nephrology : CJASN 2011;6:1599-608.   DOI
9 Ainsworth NL, Marshall A, Hatcher H, Whitehead L, Whitfield GA, Earl HM. Evaluation of glomerular filtration rate estimation by Cockcroft-Gault, Jelliffe, Wright and Modification of Diet in Renal Disease (MDRD) formulae in oncology patients. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO 2012;23:1845-53.   DOI
10 Hojs R, Bevc S, Ekart R, Gorenjak M, Puklavec L. Serum cystatin C-based formulas for prediction of glomerular filtration rate in patients with chronic kidney disease. Nephron Clinical practice 2010;114:c118-26.   DOI
11 Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clinical journal of the American Society of Nephrology : CJASN 2010;5:1003-9.   DOI
12 Itoh K, Tsukamoto E, Mochizuki T, Kanegae K, Katoh C, Tamaki N. Comparison of single sample methods for determination of plasma clearance using 99mTc-MAG3. Kaku igaku The Japanese journal of nuclear medicine 1998;35:689-95.
13 Bakoush O, Grubb A, Rippe B. Inaccuracy of GFR predictions by plasma cystatin C in patients without kidney dysfunction and in advanced kidney disease. Clinical nephrology 2008; 69:331-8.   DOI
14 Domingues FC, Fujikawa GY, Decker H, Alonso G, Pereira JC, Duarte PS. Comparison of relative renal function measured with either 99mTc-DTPA or 99mTc-EC dynamic scintigraphies with that measured with 99mTc-DMSA static scintigraphy. International braz j urol : official journal of the Brazilian Society of Urology 2006;32:405-9.   DOI
15 Takayama T, Aburano T, Shuke N, Yokoyama K, Michigishi T, Sun BF, et al. [Evaluation of renal function using 99mTc-MAG3: comparison with 123I-OIH and 99mTc-DTPA]. Kaku igaku The Japanese journal of nuclear medicine 1993;30:753-60.