Application of 99mTc-DTPA renography in the determination of GFR in living kidney donors
10.3760/cma.j.issn.0254-1785.2010.08.010
- VernacularTitle:99mTc-DTPA肾动态显像在评价活体供肾者肾小球滤过率中的应用
- Author:
Xiuyi ZHAO
;
Yahui SHAO
;
Jun TIAN
;
Ben SUN
;
Xiangtie LI
;
Aimin ZHANG
;
Junwen HAO
;
Chuanfu LI
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Living donors;
Glomerular filtration rate;
DTPA
- From:
Chinese Journal of Organ Transplantation
2010;31(8):481-484
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical application of 99mTc-DTPA renography in evaluating the glomerular filtration rate (GFR) in living donor kidney transplantation and to assess the dependence of GFR on age and gender in living kidney donors. Methods There were 212 consecutive potential donors in the study. The potential donor evaluation process included as follows: general health status, liver and kidney ultrasound, hepatitis virus infection and HLA-DR matching. If the results met the general requirements for the donor selection criteria, the GFR was measured using the 99mTc-IDTPA renography according to standard procedure (gates method). The GFR ≥ 1.33 ml/s was considered normal, ＜ 1.17 ml/s was defined as the lower limit for donor GFR, and 1.17 ml/s ≤GFR ＜ 1.33 ml/s further underwent measurement of creatinine clearance (CCr). If the CCr was normal, the GFR was considered normal, and otherwise, potential donors gave up kidney donation.All the donors meeting the donor selection criteria were divided into four age groups. On the other hand, the total donors were divided into the groups aged ＞ 55 years and aged ≤ 55 years. The impact of gender and age on GFR was evaluated preoperation due to age-related changes and gender using Kendall's tau-b correlation coefficient. Results In 212 potential donors, 137 cases had a GFR ≥ 1.33ml/s, 55 cases 1.17 ml/s ≤ GFR ＜ 1.33 ml/s and 20 cases GFR ＜ 1.17 ml/s. Thirty-one cases of potential donors with 1.17 ml/s ≤ GFR ＜ 1.33 ml/s gave up kidney donation due to abnormal CCr or other security considerations. 161 (56 females, 105 males) were qualified as successful donors, and the donor age was 42. 91 ± 11.90 years (range 20 to 62 years). The preoperative total GFR (ml/s) in living kidney donors was calculated as 1.51 ± 0.22 for males, it was 1.45 ± 0.18 for females respectively (P＞0.05). Among the four age groups, there was no significant difference in GFR (P＞0.05). The GFR in the donors aged ＞ 55 years and aged ≤ 55 years was 1.48 ± 0.22 and 1.49 ±0.17 respectively (P＞0.05). Correlation analysis revealed that the GFR in all the donors was not related with age (r = -0. 033, P = 0. 69). Also, there was no correlation between age and GFR in men and women(r= -0.053, P=0.571; r= -0.019, P=0.754). Conclusion 99mTc-DTPA renography is reliable and reproducible for the determination of GFR in living kidney donors. In view of acute donor shortage and if properly screened, kidneys with 1.17 ml/s≤ GFR ＜ 1.33 ml/s can be used without increasing the risk to donor. The GFR is not correlated with the age and gender.
