Technetium-99m-MAG3 and technetium-99m-DTPA: Renal clearance measured by the constant infusion technique - Old news? - OpacWWW

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Tytuł:: Technetium-99m-MAG3 and technetium-99m-DTPA: Renal clearance measured by the constant infusion technique - Old news?
Autorzy:: Østergaard AM; University Clinic in Nephrology and Hypertension, and University of Aarhus, Holstebro, Denmark.
Langaa SS; University Clinic in Nephrology and Hypertension, and University of Aarhus, Holstebro, Denmark.
Vrist MH; University Clinic in Nephrology and Hypertension, and University of Aarhus, Holstebro, Denmark.
Mose FH; University Clinic in Nephrology and Hypertension, and University of Aarhus, Holstebro, Denmark.
Bech JN; University Clinic in Nephrology and Hypertension, and University of Aarhus, Holstebro, Denmark.
Fynbo CA; Department of Nuclear Medicine, Gødstrup Hospital, Herning, Denmark.
Theil J; Department of Nuclear Medicine, Gødstrup Hospital, Herning, Denmark.
Ejlersen JA; Department of Nuclear Medicine, Gødstrup Hospital, Herning, Denmark.; Department of Clinical Physiology, Viborg Regional Hospital, Viborg, Denmark.
Źródło:: Clinical physiology and functional imaging [Clin Physiol Funct Imaging] 2021 Nov; Vol. 41 (6), pp. 488-496. Date of Electronic Publication: 2021 Aug 29.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Oxford : Blackwell, c2002-
MeSH Terms:: Technetium Tc 99m Mertiatide*
Technetium Tc 99m Pentetate*
Glomerular Filtration Rate ; Humans ; Kidney Function Tests ; Technetium
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Contributed Indexing:: Keywords: GFR; interventional studies; renal clearance; renal plasma flow; tracer kinetics
Substance Nomenclature:: 36ITO9SKQJ (Technetium Tc 99m Mertiatide)
7440-26-8 (Technetium)
VW78417PU1 (Technetium Tc 99m Pentetate)
Entry Date(s):: Date Created: 20210821 Date Completed: 20211025 Latest Revision: 20211025
Update Code:: 20240104
DOI:: 10.1111/cpf.12724
PMID:: 34418886
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Background: Accurate, precise and straightforward methods for measuring glomerular filtration rate (GFR) and/or renal plasma flow (RPF) are still in demand today. The time-consuming constant infusion technique (CIT) is the gold standard and preferred for research, whereas the simple, but less precise, single injection technique (SIT) is used in clinical settings. This study investigated the use of 99m Tc-DTPA and 99m Tc-MAG 3 by CIT as a measure of renal function. We developed and evaluated a model to balance the primer dose and infusion rate in an attempt to obtain plasma steady state as quickly as possible.
Methods: 14 healthy subjects received 99m Tc-DTPA and 6 hypertensive patients received 99m Tc-MAG 3 in a standardized protocol. All participants had an eGFR above 60 ml/min and none had fluid retention. An intravenous primer injection of the relevant tracer was followed by a sustained infusion over 4.5 h with the same radiopharmaceutical. Blood and urine samples were collected at fixed intervals.
Results: 99m Tc-DTPA clearance reached steady state after 210 min (plasma clearance 78 ± 18 ml/min, urine clearance 110 ± 28 ml/min), whereas 99m Tc-MAG 3 clearance achieved steady state after 150 min (plasma clearance 212 ± 56 ml/min, urine clearance 233 ± 59 ml/min).
Conclusion: Constant infusion technique with fixed primer and infusion rate using 99m Tc-MAG 3 is feasible for research purposes. The longer time for reaching plasma steady state using 99m Tc-DTPA makes CIT with this tracer less optimal. If the primer/sustained balance can be optimized, for example using a priori SIT information, 99m Tc-DTPA as tracer for CIT may also be feasible.
(© 2021 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

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Technetium-99m-MAG3 and technetium-99m-DTPA: Renal clearance measured by the constant infusion technique - Old news?