A comparison between estimates of glomerular filtration rate using technetium-99m-diethylene-triamine-pentaacetic acid clearance and modification of diet in renal disease equation

Abstract

More than half of cancer patients have unrecognized renal insufficiency, which is a reduced glomerular filtration rate (GFR) and is a disease complication factor. <b>Aims and Objectives:</b> The objective of the present study is to compare the accuracy of GFR with two methods, i.e., GFR by Gates' method (gamma camera uptake method with technetium-99m-diethylene-triamine-pentaacetic acid (Tc-99m-DTPA) and GFR by modification of diet in renal disease (MDRD) equation in cancer patients. <b>Materials and Methods:</b> A total of 50 cancer patients with abnormal serum creatinine were included in the study. 50 age matched cancer patients with normal creatinine, blood urea nitrogen (BUN) and serum albumin were taken as controls. History of patients including site of cancer, chemotherapy regime and dose of chemotherapy was recorded. Serum creatinine was estimated by auto analyzer using Jaffe's method. Glomerular filtration rate (GFR) was calculated using camera based modified gates method with (99mTc-DPTA) and MDRD equation. <b>Results:</b> Mean age of patients was 50 year. Level of serum creatinine and BUN were significantly increased (P &lt; 0.001) in patients when compared to controls. Level of serum albumin was non-significantly (<i>P</i> &gt; 0.05) decreased in cancer patients and body surface area also increased, but differences were non-significant (<i>P</i> &gt; 0.05) in cancer patients when compared to controls. Mean GFR was estimated by camera based modified gates method which increased in cancer patients as compared to GFR by MDRD equation but differences were not significant (<i>P</i> &gt; 0.05). Cost, time duration and time for reagent preparation was very high using Renogram (Gate's method) as compared to the cost and other factors involved in estimation of GFR by MDRD equation. <b>Conclusion:</b> It is concluded that the MDRD equation is more suitable, economical and time saving for the estimation of GFR as compared to Renogram using Tc-99m-DPTA. However future prospective studies are required to the estimation of GFR in those tumors, which may cause kidney damage such as cisplatin or carboplatin, methotrexate.