Utility of radioisotopic filtration markers in chronic renal insufficiency: Simultaneous comparison of sup 125 I-iothalamate, sup 169 Yb-DTPA, sup 99m Tc-DTPA, and inulin. The Modification of Diet in Renal Disease Study

Journal Article · Sat Sep 01 04:00:00 EDT 1990 · American Journal of Kidney Diseases; (USA)

DOI:https://doi.org/10.1016/S0272-6386(12)81022-5· OSTI ID:6509922

Perrone, R D; Steinman, T I; Beck, G J; Skibinski, C I; Royal, H D; Lawlor, M; Hunsicker, L G ^[1]

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1. National Institute of Diabetes, Digestive, and Kidney Diseases, Bethesda, MD (USA)

Assessment of glomerular filtration rate (GFR) with inulin is cumbersome and time-consuming. Radioisotopic filtration markers have been studied as filtration markers because they can be used without continuous intravenous (IV) infusion and because analysis is relatively simple. Although the clearances of 99mTc-DTPA, 169Yb-DTPA, and 125I-iothalamate have each been compared with inulin, rarely has the comparability of radioisotopic filtration markers been directly evaluated in the same subject. To this purpose, we determined the renal clearance of inulin administered by continuous infusion and the above radioisotopic filtration markers administered as bolus injections, simultaneously in four subjects with normal renal function and 16 subjects with renal insufficiency. Subjects were studied twice in order to assess within-study and between-study variability. Unlabeled iothalamate was infused during the second half of each study to assess its effect on clearances. We found that renal clearance of 125I-iothalamate and 169Yb-DTPA significantly exceeded clearance of inulin in patients with renal insufficiency, but only by several mL.min-1.1.73m-2. Overestimation of inulin clearance by radioisotopic filtration markers was found in all normal subjects. No differences between markers were found in the coefficient of variation of clearances either between periods on a given study day (within-day variability) or between the two study days (between-day variability). The true test variability between days did not correlate with within-test variability. We conclude that the renal clearance of 99mTc-DTPA, 169Yb-DTPA, or 125I-iothalamate administered as a single IV or subcutaneous injection can be used to accurately measure GFR in subjects with renal insufficiency; use of the single injection technique may overestimate GFR in normal subjects.

• OSTI ID: 6509922
• Journal Information: American Journal of Kidney Diseases; (USA), Journal Name: American Journal of Kidney Diseases; (USA) Vol. 16:3; ISSN 0272-6386; ISSN AJKDD
• Country of Publication: United States
• Language: English

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550901* -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
AMINO ACIDS
AZOLES
BETA DECAY RADIOISOTOPES
BIOLOGICAL MARKERS
BODY
CARBOHYDRATES
CARBOXYLIC ACIDS
CHELATING AGENTS
CLEARANCE
COMPARATIVE EVALUATIONS
CREATININE
DAYS LIVING RADIOISOTOPES
DISEASES
DRUGS
DTPA
ELECTRON CAPTURE RADIOISOTOPES
EVEN-ODD NUCLEI
EXCRETION
HETEROCYCLIC COMPOUNDS
IMIDAZOLES
IMINES
INTERMEDIATE MASS NUCLEI
INULIN
IODINE 125
IODINE ISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KIDNEYS
LABELLED COMPOUNDS
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
PATHOGENESIS
POLYSACCHARIDES
RADIOISOTOPES
RADIOPHARMACEUTICALS
RADIOPROTECTIVE SUBSTANCES
RARE EAR
RARE EARTH NUCLEI
RENAL CLEARANCE
SACCHARIDES
UROGENITAL SYSTEM DISEASES
YTTERBIUM 169
YTTERBIUM ISOTOPES