Abstract
A camera-based method using Technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) is commonly used to calculate glomerular filtration rate (GFR), especially, as it can easily calculate split renal function. Renal depth is the main factor affecting the measurement of GFR accuracy. This study aimed to compare the difference of renal depths between three formulae and a CT scan, and, additionally, to calculate the GFRs by four methods. We retrospectively reviewed the medical records of patients receiving a renal dynamic scan. All patients underwent a laboratory test within one month, and a computed tomography (CT) scan within two months, before or after the renal dynamic scan. The GFRs were calculated by employing a renal dynamic scan using renal depth measured in three formulae (Tonnesen’s, Itoh K’s, and Taylor’s), and a CT scan. The renal depths measured by the above four methods were compared, and the GFRs were compared to the modified estimated GFR (eGFR). Fifty-one patients were enrolled in the study. The mean modified eGFR was 60.5 ± 42.7 mL/min. The mean GFRs calculated by three formulae and CT were 45.3 ± 23.3, 54.7 ± 27.5, 56.5 ± 26.3, and 63.7 ± 30.0, respectively. All of them correlated well with the modified eGFR (r = 0.87, 0.87, 0.87, and 0.84, respectively). The Bland–Altman plot revealed good consistency between the calculated GFR by Tonnesen’s and the modified eGFR. The renal depths measured using the three formulae were smaller than those measured using the CT scan, and the right renal depth was always larger than the left. In patients with modified eGFR > 60 mL/min, the GFR calculated by CT was the closest to the modified eGFR. The Renal depth measured by CT scan is deeper than that using formula, and it influences the GFR calculated by Gate’s method. The GFR calculated by CT is more closely related to modified eGFR when modified eGFR > 60 mL/min.
Highlights
People suffering from chronic kidney disease (CKD), acute kidney injury (AKI), and renal replacement therapy exceed 805 million in total [1]
Inulin clearance has been the widely accepted gold standard [3] for measuring the glomerular filtration rate (GFR), this methodology is time-consuming, expensive, and not available, making it unsuitable for routine clinical use. Some equations such as Cockcroft–Gault (CG) [4], modification of diet in renal disease (MDRD) [5], and CKD epidemiology collaboration (CKD-EPI) [6], which estimate GFRs based on serum creatinine measurement with ease and convenience, have been widely accepted for clinical use
We found that the GFR calculated by four methods were all well correlated to the modified estimated GFR (eGFR)
Summary
People suffering from chronic kidney disease (CKD), acute kidney injury (AKI), and renal replacement therapy exceed 805 million in total [1]. Renal diseases are a notable public health issue and a leading, heavy, burden on the medical system. Inulin clearance has been the widely accepted gold standard [3] for measuring the GFR, this methodology is time-consuming, expensive, and not available, making it unsuitable for routine clinical use. Some equations such as Cockcroft–Gault (CG) [4], modification of diet in renal disease (MDRD) [5], and CKD epidemiology collaboration (CKD-EPI) [6], which estimate GFRs based on serum creatinine measurement with ease and convenience, have been widely accepted for clinical use
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