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admin | Matrix Exercise Equipment | 21.03.2015
Materials and Methods: Study design retrospectively in 59 patients with serum creatinine value calculated for SCrCl with Cockcroft and Gault's formula as an index parameter for kidney function underwent the 99m-Technitium labeled Di-ethyl Triamine Penta Acetic Acid (99mTc-DTPA) renogram with ECIL planar gamma camera.
Correlation between glomerular filtration rate with gamma camera and estimated serum creatinine clearance from Cockcroft and Gault's formula. Measurement of glomerular filtration rate with technetium-99mDTPA: Comparison of plasma clearance techniques. Creatinine clearance estimation from Serum creatinine values: An analysis of three mathematical model of Glomerular function. Results: All data of 59 patients has been divided into Group- I, II, and III based on the time difference of serum creatinine test from 99mTc-DTPA renal GFR tests performed on the same subjects.
The measurement of Glomerular filtration rate (GFR) is based on the concept of clearance [1] through the kidneys. Urea, insulin, and creatinine clearance (CrCl) tests are used to examine impairment of glomerular filtration. Although, inulin clearance is considered as gold standard but this method is impractical for routine use due to cumbersome methodology.
99m-Technitium labeled Di-ethyl Triamine Penta Acetic acid (Tc99m-DTPA) clearance as renogram with the gamma camera method is much simpler and popular in routine clinical practice compared to plasma sampling method to measurement of GFR.
Gamma camera Di-ethyl Triamine Penta Acetic Acid (DTPA) renogram provides GFR [2],[3] to know the split kidney function as well.At the same time estimated Serum creatinine clearance (SCrCl) [4] with the Cockcroft and Gault's formula is simple and easy to know the instant global kidney function. Conclusions: Study concludes that SCrCl using Cockcroft and Gault's formula could serve as an instant, easy, and reliable method for assessing kidney function.

The estimated CrCl is the choice of investigation for assessing the functional status of kidneys. SCrCl with Cockcroft and Gault's formula is more useful for rapid estimation of global GFR for those patients who are not accessible to DTPA renogram with gamma camera. In this present study, it has been tried to establish the validity of estimated SCrCl from serum creatinine using Cockcroft and Gault's formula in relation to GFR measured by using radionuclide gamma camera method as a marker of renal dysfunction.
Freeze dried DTPA kit (TCK-7) procured from board of radiation and isotope technology was labeled by adding 50-60 mCi in 3-4 ml of Technetium-99m sodium pertechnetate following manufacturer's protocol.
Planar gamma camera (ECIL, Hyderabad) fitted with low energy all purpose (LEAP) collimator was used to measure GFR of all the patients. Fifty nine patients of age between 5 years and 55 years were selected and CrCl was calculated using the formula of CG.
In adult patient, generally, 3-4 mCi Tc99m-DTPA is administered intravenously through bolus injection. Injection and data acquisition is started simultaneously and the data is acquired in frame mode.
Regions of interest were drawn around each kidney while background region was drawn lateral to each kidney.The GFR is calculated using gate's formula in renal software. Patient height (in cm) weight (in kg), age (in years) and sex are fed as input according to the program. Statistical analysis of the three groups reveals that the value of correlation coefficient of Group-I is more than that of the Group-II and that of Group-II is more than Group-III.

The data shows that the level of significance of Group-I is much more than that of Group-II and III. This implies than more nearly the time of measurements of serum creatinine level to the measurement of GFR of the patient, more is the value of correlation coefficients.
Each indicates that serum creatinine may be a tool for the evaluation of kidney functions where nuclear medicine facilities are not commonly available.
There is less number of specialized health center as well as limited resources for such a large population. In such situation, SCrCl using Cockcroft and Gault's formula may serve the purpose because this method has proven accuracy and is easier to perform than any other method of kidney function evaluation. On the other hand, GFR measured by 99mTc-DTPA scintigraphy [6],[7] is also significant because of its accuracy and reproducibility of the measurement being very high.
It is a fast and easy method being computerized and through this method differential kidney GFR can be determined.

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