The renal function as assessed by 99mTc-DTPA renal dynamic imaging and Cockcroft-Gault formula: a comparison study

Xiu-qin Liu, Yue Guo, Zhiguo Yu, S. Qin
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Abstract

Objective To evaluate the difference of the glomerular filtration rate (GFR) estimated by99mTc-DTPA renal dynamic imaging (gGFR) and Cockcroft-Gault (C-G) formula(eGFR), and the consistency in the staging of the chronic kidney disease patients. Methods gGFR and eGFR were calculated from the data of 945 chronic kidney disease patients who underwent the dynamic renal imaging. Wilcoxon test was performed to determine the difference of the two and the Spearman test for the correlation. Kappa test was used to evaluate the consistency of the staging of the patients, according to the gGFR and eGFR respectively. Results (1) The global eGFR (median 51.8)was significantly higher than gGFR(median 44.6),Z=-12.53,P<0.001; (2) there was a strong correlation between gGFR and eGFR (r=0.719,P<0.001); (3) the patients were divided into 3 stages (compensatory stage, moderately decreased stage and severely decreased stage ) according to eGFR and gGFR respectively, the global coincidence rate was 63.3% (598/945) with moderate consistency (Kappa=0.405,P<0.001); (4) when the patients were divided into 5 stages according to the gGFR, the serum creatinine value showed significant difference between every two stages (P<0.001) except stage1 and 2 (Z=-1.844,P=0.065), and the creatinine value increased as the stage going up. Conclusion There was a strong correlation between the GFR value estimated by99mTc-DTPA renal dynamic imaging and C-G formula, and a moderate consistency in the staging of the chronic renal disease patients. The two methods are complementary with each other and should be comprehensively utilized to accurately assess the renal function. Key words: Glomerular filtration rate; Renal fuction; DTPA
99mTc-DTPA肾动态显像与Cockcroft-Gault公式评价肾功能的比较研究
目的探讨99mtc - dtpa肾动态显像(gGFR)与Cockcroft-Gault (C-G)公式(eGFR)测定的肾小球滤过率(GFR)的差异及对慢性肾病患者分期的一致性。方法对945例慢性肾脏病患者行动态肾显像,计算gGFR和eGFR。采用Wilcoxon检验确定两者的差异,采用Spearman检验确定两者的相关性。分别根据gGFR和eGFR采用Kappa试验评价患者分期的一致性。结果(1)全球eGFR(中位数51.8)显著高于gGFR(中位数44.6),Z=-12.53,P<0.001;(2) gGFR与eGFR相关性较强(r=0.719,P<0.001);(3)根据eGFR和gGFR分别将患者分为代偿期、中度下降期和重度下降期3个阶段,整体符合率为63.3%(598/945),一致性中等(Kappa=0.405,P<0.001);(4)将患者按gGFR分为5期时,除1期和2期外,其余2期血清肌酐值差异均有统计学意义(P<0.001) (Z=-1.844,P=0.065),且随着分期的增加,肌酐值逐渐升高。结论99mtc - dtpa肾动态显像估测的GFR值与C-G公式有较强的相关性,对慢性肾病患者的分期具有中等一致性。两种方法相辅相成,应综合运用才能准确评估肾功能。关键词:肾小球滤过率;肾脏功能;二乙三胺五醋酸
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