engleski

Is There a Correlation Between MAG3 Tubular Extraction Rate and Estimated Glomerular Filtration Rate in Transplanted Kidney?

Aim. The aim of study was to investigate correlation of MAG3 tubular extraction rate (TER) in patients with transplanted kidney calculated by MAG3 dynamic scintigraphy (gamma camera method without blood samples) and stage of chronic kidney disease (CKD) based on estimated glomerular filtration rate (eGFR) calculated by CKDEPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Patients and Methods: The prospective study was based on evaluation of 205 consecutive patients who underwent 99mTc- MAG3 dynamic scintigraphy of transplanted kidney between July 2012 and January 2017. The applied activity was 300 MBq and graft depth was determined by lateral view static imaging. MAG3 TER or clearance of MAG3 was calculated by “slope method” by Inou. Those patients who had values of TER MAG3 above 90 ml/min were selected. Finally, 84 patients, 38 men (mean age 57, range 26-76) and 46 women (mean age 59, range 35-76) were recruited in the study. In each subject, within 24 hours from scintigraphy, eGFR was calculated by CKD-EPI equation from serum creatinine level modified by demographical parameters (gender, age and race). Also all other available scintigraphic and clinical parameters were analysed with focus on the functional status of graft. Results: The range of TER values was 98-284 ml/min and calculated median clearance and standard deviation were 150 ml/min and 38 ml/ min, respectively. One patient had eGFR >90 ml/min, TER MAG3 215 ml/min (stage 0 of CKD), eight patients had eGFR 60-89 ml/ min, average TER MAG3 204 ml/min (stage 1 of CKD), 27 patient had eGFR 45-59 ml/min, average TER MAG3 163 ml/min (stage 2 of CKD), 37 patients had eGFR 30-44 ml/min, average TER MAG3 139 ml/min (stage 3 of CKD), 11 patients had eGFR 15-29 ml/min, average TER MAG3 138 ml/min (stage 4 of CKD). Conclusion: In patients with transplanted kidney there is a correlation between MAG3 TER calculated by gamma camera method without blood samples and stage of CKD based on eGFR calculated by CKD-EPI. However, there is a range of MAG3 TER for each stage of CKD. Consequently, the functional status of graft can be evaluated by MAG3 scintigraphy in addition to standard analysis of perfusion, morphology and excretory function of the graft. A further prospective study in a greater number of patients should be done.

MAG3 tubular extraction rate ; estimated glomerular filtration rate ; transplanted kidney

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