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A multi-center study comparing in vitro GFR, technetium-99m-diethylenetriaminepentacetic acid (99MTC-DTPA) renogram, and cockroft and gault formula for the estimation of glomerular filtration rate.

Author

Emily Rose Jerdeleza,
Kathleen Caligagan,
Leandro Manalaysay,
Jocelyn Cobankiat,
Ofelia P. Javellana,
Melanie V. Tan-Tantuco

Related Institution

Publication Information

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Journal of Nephrology
Frequency
Semi-Annual
Publication Date
July-December 2004
Volume
19
Issue
2
Page(s)
4-14

Abstract

Background: Creatinine clearance (CCr) is a commonly used tool to measure glomerular filtration rate (GFR) in clinical practice. Several different formulae have been used to estimate GFR using plasma creatinine but a new rapid method for determining GFR by radionuclide compound (99mTcDTPA) has been developed and widely used in the last decade.

Objective: The purpose of this study is to compare estimation of glomerular filtration rate (GFR) using the In vitro GFR and the Cockroft and Gault (C-G) CCr equation with the standard estimation measured from 99m Tc-DTPA renography and determine the effects of parameters such as age, BMI, weight, height and serum creatinine on estimation of GFR based on the 3 methods.

Design: Multi-center, retrospective

Patients/Setting: The study included 251 patients with various degrees of renal dysfunction who were studied at Cardinal Santos Medical Center and St. Luke's Medical Center from January 2001 to September 2003.

Intervention: All patients underwent both 99mTc DTPA GFR and In vitro GFR. 99mTc DTPA computed GFR was calculated using the formula of Gates. C-G equation was also used to compare with the two methods. Estimates were initially correlated with the 99mTc-DTPA values using Pearson correlation coefficient. Linear regression analyses were performed with software (SPSS version 10.0) to determine the contribution of different parameters on various GFR estimates.

Results: The radionuclide computed GFR for each subject was compared with his or her In vitro GFR and C-G estimation of GFR. C-G estimate is more correlated to the Gates formula than the In vitro estimate (correlation coefficient of 0.847 vs. 0.536) using bivariate statistics. Between In-vitro estimate and 99m Tc-DTPA GFR, a correlation coefficient of 0.536 was arrived at with a standard error of the estimate at 28.46. Between the C-G equation and 99m Tc-DTPA GFR, a correlation coefficient of 0.847 with a standard error of the estimate at 17.92 was computed, both yielded a linear relationship. Based on the linear correlation and standard errors of the estimate, the C-G equation provided a better estimate of the 99m Tc-DTPA with a smaller standard error of the estimate. The greatest negative correlation for age and serum creatinine was found with the C-G equation. For the body mass Index (BMI), C-G was the only other variable which was positively correlated.

Conclusions: All methods gave good correlations when all of the subjects with a wide range of CCr were considered, but the formula of C-G gave the better estimate than In vitro GFR. In older people and those with renal dysfunction, the C-G formula for assessing the CCr correlated extremely well with the standard clinical tests such as 99m Tc DTPA and better than in vitro GFR for measuring the GFR. Obese patients have higher GFR estimate using C-G, but lower GFR estimate with Tc-DTPA renogram. (Author)

Objectives

The purpose of this study is to compare estimation of glomerular filtration rate (GFR) using the In vitro GFR and the Cockroft and Gault (C-G) CCr equation with the standard estimation measured from 99m Tc-DTPA renography and determine the effects of parameters such as age, BMI, weight, height and serum creatinine on estimation of GFR based on the 3 methods.

Physical Location

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Box No. 53 Fulltext Print Format

 
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