Glomerular Filtration Rate Measurements Using <sup>99m</sup>Technetium-mercaptoacetyltriglycine Dynamic Renal Scintigraphy in Children with Renal Disease

Yoon, In Ae; Yun, Ki Wook; Lim, In Seok; Choi, Eung Sang; Yoo, Byung Hun

doi:2013.17.2.57

J Korean Soc Pediatr Nephrol > Volume 17(2); 2013 > Article

Original Article

J Korean Soc Pediatr Nephrol 2013;17(2): 57-64. doi: https://doi.org/10.3339/jkspn.2013.17.2.57

신장 질환이 있는 소아에서 ^99mTechnetium-mercaptoacetyltriglycine (^99mTc-MAG3) 신장 스캔에 의한 사구 체 여과율 측정

윤인애, 윤기욱, 임인석, 최응상, 유병훈

중앙대학교 의과대학 소아청소년과

Glomerular Filtration Rate Measurements Using ^99mTechnetium-mercaptoacetyltriglycine Dynamic Renal Scintigraphy in Children with Renal Disease

In Ae Yoon, Ki Wook Yun, In Seok Lim, Eung Sang Choi, Byung Hun Yoo

Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea

Corresponding Author: In Seok Lim ,Tel: 02-6299-1477, Fax: 02-6264-2167, Email: inseoklim@cau.ac.kr

Received: June 1, 2013; Accepted: July 2, 2013.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons. org/licenses/bync/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Purpose: In children, 24-hour urine collections are unreliable for evaluating glomerular filtration rate (GFR) because of the difficulty of regulating voiding and the daily variation of urinary creatinine up to 25%. Additionally, creatinine clearance (Ccr) based on urinary creatinine is considered inaccurate. The purpose of this study was to compare estimated GFR determined using Ccr, formulas with serum cystatin C and creatinine, and ^99mTc-mercaptoacetyltriglycine (MAG3) dynamic renal scintigraphy.

Methods: This retrospective study included 101 patients (age, <18 years) who visited Chung-Ang University Hospital between July 2011 and August 2012. GFR was estimated using 24-hour urinary creatinine, five formulas with serum creatinine and cystatin C, and ^99mTc-MAG3 renal scan.

Results : Of the 101 patients, glomerular renal diseases were present in 60 patients (59.4%) and non-glomerular diseases were present in 41 patients (40.6%). There was a significant correlation between estimated GFR determined using ^99mTc- MAG3 renal scan and Ccr (r=0.389, P <0.001). The correlation values between estimated GFR determined using ^99mTc-MAG3 renal scan and each formula of Schwartz, Counahan-Barratt, Cockcroft-Gault, Filler and Lepage, and Bokencamp were 0.265 (P=0.007), 0.128 (P=0.044), 0.230 (P=0.021), 0.356 (P<0.001), and 0.355 (P <0.001), respectively. ^99mTc-MAG3 renal scan was correlated with estimated- GFR by all formulas in decreased renal function.

Conclusion : Estimated GFRs determined using serum creatinine and cystatin C, and ^99mTc-MAG3 renal scan correlated well with estimated GFR determined using Ccr. ^99mTc-MAG3 renal scan may be replaced for evaluation of renal function with convenience in patients with renal disease and decreased renal function in childhood.

Key words: Glomerular filtration rate | Creatinine clearance | ^99mTc-MAG3 renal scintigraphy