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学科主题: 临床医学
题名:
Comparison of Tc-99m-DTPA renal dynamic imaging with modified MDRD equation for glomerular filtration rate estimation in Chinese patients in different stages of chronic kidney disease
作者: Ma, Ying-Chun; Zuo, Li; Zhang, Chun-Li; Wang, Mei; Wang, Rong-Fu; Wang, Hai-Yan
关键词: dual plasma sample method ; glomerular filtration rate ; modified abbreviated MDRD equation ; renal dynamic imaging ; Tc-99m-DTPA
刊名: NEPHROLOGY DIALYSIS TRANSPLANTATION
发表日期: 2007-02-01
DOI: 10.1093/ndt/gfl603
卷: 22, 期:2, 页:417-423
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Transplantation ; Urology & Nephrology
研究领域[WOS]: Transplantation ; Urology & Nephrology
关键词[WOS]: PLASMA-CLEARANCE ; GAMMA-CAMERA ; FORMULAS ; INULIN ; DEPTH ; ACID ; DTPA
英文摘要:

Background. The renal dynamic imaging method (modified Gate′s method) with Tc-99m-diethylene triamine pentaacetic acid (Tc-99m-DTPA) is simple and less time consuming for glomerular filtration rate (GFR) estimation than other methods. However, its diagnostic performance as a surrogate marker of GFR is questioned increasingly. Recently, the modified Modification of Diet in Renal Disease (MDRD) study equation based on data from Chinese patients of chronic kidney disease (CKD) showed significant performance improvement. In the present study, the renal dynamic imaging methods and the modified abbreviated MDRD equation were compared with the plasma clearance method.

Methods. Four hundred and eighty two patients with CKD were selected. GFR were estimated simultaneously using three methods: (i) modified Gate′s method (gGFR); (ii) the modified abbreviated MDRD equation (c-aGFR) and (iii) dual plasma sampling method (rGFR). Using rGFR as the reference method, gGFR and c-aGFR were compared with rGFR in each stage of CKD.

Results. Both gGFR and c-aGFR were correlated well with rGFR (r(gGFR) = 0.81 and r(c-aGFR) = 0.90, P < 0.001). In the overall performance, c-aGFR had less bias (849.5 vs 933.1 arbitrary units), higher precision (57 vs 78.4 ml/min/1.73 m(2)) and higher accuracy than gGFR. For gGFR, the 15, 30 and 50% accuracies were 32.4, 56.0 and 79.1%, respectively; for c-aGFR, the corresponding accuracy rose to 43.2%, 75.5% and 90.9%, respectively. In each stage of CKD, the modified abbreviated MDRD equation also outperformed the modified Gate′s method in the GFR estimation.

Conclusion. Our results indicated that the performance of the renal dynamic imaging in total GFR estimation was not better than the modified abbreviated MDRD equation in our patient group, and should not be used as a surrogate marker of GFR, especially in clinical trials. We presume that the dynamic renal imaging methods for estimation of GFR can be improved by using proper reference GFR, more adequate background subtraction and soft-tissue attenuation correction, in a relatively larger sample size.

语种: 英语
WOS记录号: WOS:000243805400019
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55605
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Peking Univ, Hosp 1, Div Nephrol, Beijing 100034, Peoples R China
2.Peking Univ, Hosp 1, Inst Nephrol, Beijing 100034, Peoples R China
3.Peking Univ, Hosp 1, Inst Nucl Med, Beijing 100034, Peoples R China

Recommended Citation:
Ma, Ying-Chun,Zuo, Li,Zhang, Chun-Li,et al. Comparison of Tc-99m-DTPA renal dynamic imaging with modified MDRD equation for glomerular filtration rate estimation in Chinese patients in different stages of chronic kidney disease[J]. NEPHROLOGY DIALYSIS TRANSPLANTATION,2007,22(2):417-423.
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