HYDRATED CLEARANCE OF GADOLINIUM-DTPA AS A MEASUREMENT OF GLOMERULAR-FILTRATION RATE
HYDRATED CLEARANCE OF GADOLINIUM-DTPA AS A MEASUREMENT OF GLOMERULAR-FILTRATION RATE
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DOI：
10.1038/ki.1992.230
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发表时间：
1992-06-01
影响因子：
19.6
通讯作者：
SIMON, T
中科院分区：
文献类型：
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作者：
CHOYKE, PL;AUSTIN, HA;SIMON, T
钆-DTPA的水合清除率作为肾小球滤过率的测量。 锝（Tc-99 m）-二乙烯三胺五乙酸（DTPA）水合清除率研究可准确测定GFR，但需要特殊设施来处理和测量样本。 我们研究了非放射性顺磁类似物钆（Gd）-二乙烯三胺五乙酸（DTPA）作为肾小球滤过标记物的潜力，DTPA是一种获批的NMR造影剂。 该测试不是依赖于锝的放射性，而是基于钆诱导血液和尿液样品中NMR T1弛豫时间的改变的事实。 90例患者接受了使用1 mCi Tc-DTPA和0.05 mmol/kg Gd-DTPA（Berlex Labs）IV同时测定GFR。 患者口服和静脉补液。 在1小时平衡期后，连续采集3或4次尿液;在每个约20分钟间隔的开始和结束时采集血浆样本。 用闪烁计数器测定Tc-99 m-DTPA放射性。 在10 MHz NMR光谱仪上测量T1弛豫时间。 通过与标准溶液进行比较，将其转换为Gd-DTPA浓度。 Gd-DTPA法测定的GFR与Tc-99 m-DTPA法测定的GFR非常接近，其范围为15 ~ 147 ml/min，回归方程和相关系数为y = 1.04x-2.2，r = 0.94。 因此，Gd-DTPA是一种安全的、非放射性的GFR指标，可为进行性肾病和肾毒性的临床研究提供替代的肾清除方法。
Hydrated clearance of gadolinium-DTPA as a measurement of glomerular filtration rate. Technetium (Tc-99m)-diethylene triamine pentaacetic acid (DTPA) hydrated clearance studies are accurate for determining GFR but require special facilities for handling and measuring samples. We investigated the potential of a non-radioactive paramagnetic analog, Gadolinium (Gd)-diethylene triamine pentaacetic acid (DTPA), an approved NMR contrast agent, as a glomerular filtration marker. Instead of relying on the radioactivity of technetium, this test is based on the fact that gadolinium induces alterations in the NMR T1 relaxation times in blood and urine samples. Ninety patients underwent simultaneous determinations of GFR using 1 mCi of Tc-DTPA and 0.05 mmol/kg Gd-DTPA (Berlex Labs) IV. The patients were hydrated with oral and intravenous fluid. Following a one hour equilibrium period, three or four consecutive urine collections were obtained; plasma samples were acquired at the beginning and end of each approximately 20-minute interval. Tc-99m-DTPA radioactivity was determined with a scintillation counter. T1 relaxation times were measured on a 10 MHz NMR spectrometer. These were converted to Gd-DTPA concentration by comparison with standard solutions. The Gd-DTPA derived GFR closely approximated the Tc-99m-DTPA derived GFR which ranged from 15 to 147 ml/min. The equation and correlation coefficient of the regression line is y = 1.04 x -2.2, r = 0.94. Thus, Gd-DTPA is a safe, non-radioactive indicator of GFR that may provide an alternative renal clearance method for clinical studies of progressive renal disease and nephrotoxicity.