대한신장학회

논문분류	춘계학술대회 초록집
제목	Performance of Technetium-99m Diethylenetriaminepentaacetic Acid Camera-Based Renography in Estimation of Glomerular Filtration Rate in Kidney Transplant Donors: A Single Center Five Years' Experience
저자	Thana Thongsricome
출판정보	2025; 2025(1):
키워드	glomerular filtration rate, diethylenetriaminepentaacetic acid renography, creatinine clearance, Chronic Kidney Disease Epidemiology Collaboration, living-donor kidney transplantation
초록	Assessment of exact glomerular filtration rate (GFR) is crucial for the management of various kidney diseases. For living-donor kidney transplantation, inaccurate GFR estimation could lead to inappropriate selection or denial of potential donors. The gold standard for GFR measurement, inulin or diethylenetriaminepentaacetic acid (DTPA) clearance, requires timed blood and urine collection and is inconvenient in clinical practice. A novel camera-based renography is less time-consuming and has been compared with the clearance technique with conflicting results. This study was conducted to assess the agreement between these estimations in living kidney donors. Clinical data from all potential kidney donors evaluated at King Chulalongkorn Memorial Hospital from 1 January 2019 to 31 December 2023 were retrospectively reviewed. Camera-based Technetium-99m DTPA renography using Gate’s method from each kidney was conducted in all subjects. Bland-Altman plots were conducted to assess the agreement between this GFR estimation and traditional creatinine clearance (CrCL), estimated GFR with Chronic Kidney Disease Epidemiology Collaboration (eGFRCKD-EPI), and Thai equation (eGFRThai). One hundred and fifty-seven donors (aged 42±12 years, male 38%, diabetes 2.5%, eGFRCKD-EPI 102±21 mL/min/1.73m2) were included. Summation of camera-based GFR of both kidneys significantly overestimated CrCL, eGFRCKD-EPI, and eGFRThai by 13.2, 13.5, and 14.1 mL/min/1.73 m2, respectively with moderate correlation coefficients (r 0.30, 0.53, and 0.50, respectively). No bias was detected between CrCL and eGFRCKD-EPI or eGFRThai. However, correlation coefficients of the camera-based method and eGFRCKD-EPI/eGFRThai are higher than those of CrCL and eGFRCKD-EPI/eGFRThai (Figure 1). As compared to the CrCL technique, camera-based Technetium-99m DTPA renography has non-inferior correlation coefficients to eGFRCKD-EPI/eGFRThai, but with the ability to separately measure GFR in each kidney. This novel method is promising but requires technical modification to account for the overestimation and validation with the gold standard GFR measurement.
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