Accuracy of glomerular filtration rate measured by 99Tc m-DTPA renal dynamic imaging (Gates method) in heart transplant recipients
10.3760/cma.j.cn321828-20200420-00159
- VernacularTitle:99Tc m-DTPA肾动态显像Gates法测定心脏移植患者肾小球滤过率的准确性探讨
- Author:
Wen ZHANG
1
;
Yan CHEN
;
Xiaonan FANG
;
Nan JIANG
;
Feng GUO
;
Zhanli FU
;
Wei FANG
;
Hongxing WEI
Author Information
1. 中国医学科学院、北京协和医学院、国家心血管病中心阜外医院核医学科 100037
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2020;40(7):406-410
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the accuracy of glomerular filtration rate (GFR) assessed from the renal dynamic imaging method (Gates method) with 99Tc m-diethylene triamine pentoacetic acid (DTPA) in the heart transplant population. Methods:From September 2017 to June 2018, 34 patients with advanced heart failure who were prepared for surgery (30 males, 4 females; age: (45±14) years; heart transplant group) and 41 patients with normal heart function (19 males, 22 females; age: (50±17) years; control group) in Fuwai Hospital were respectively enrolled. GFRs of all patients were measured using Gates method (gGFR) and dual plasma sample method (DPSM; dGFR) with 99Tc m-DTPA. The accuracy of Gates method for detecting GRF was verified by using DPSM as the reference. Seventeen patients in heart transplant group underwent 99Tc m-DTPA renal dynamic imaging for Gates and DPSM results repeatedly after the surgery. The single kidney (left and right) functions (dGFRL and dGFRR) of DPSM were obtained according to the results of Gates method. Pearson correlation analysis and paired t test were used to analyze the data. Results:The gGFR in heart transplant group was higher than dGFR ((66.49±15.66) vs (49.16±13.24) ml·min -1·1.73 m -2; t=6.728, P<0.01), and there was a moderate correlation between them ( r=0.467, P<0.01). No difference between gGFR and dGFR in control group was observed ((65.35±26.28) vs (62.22±21.37) ml·min -1·1.73 m -2; t=1.268, P=0.212), and there was a good correlation between them ( r=0.799, P<0.01). The difference between 2 correlation coefficients was statistically significant ( z=-2.44, P<0.05). Serum creatinine decreased, while dGFR, dGFRL and dGFRR increased after the surgery, suggesting the improved renal function. Conclusions:The renal dynamic imaging method (Gates method) with 99Tc m-DTPA has less accuracy in the heart transplant patients. Combination of DPSM and Gates method can provide the precise total GFR and assess single kidney GFR, and may serve as a tool to monitor the renal function for the heart transplant patients in clinic.
