[Calculation of renal clearance by dynamic measurement of excreted activity]

In this paper we present a new method to measure the renal slope-clearance of Tc-99m-MAG-3 in a single-shot model (Excretion-clearance).

A renal scintigraphy with Tc-99m-MAG-3 was performed in 22 patients. The excreted activity of the tracer in the kidneys and the bladder was dynamically measured using a double-head gamma-camera. Additionally the total absorption over the kidneys and the bladder was determined. The Excretion-clearance was calculated in a differential and an integral variant. Simultaneously the 2-compartment-clearance (Sapirstein-clearance), the Oberhausen-clearance and the Bubeck-clearance were calculated.

The Sapirstein-clearance is considered as the "gold standard" in a single-shot model. The correlation of the Bubeck-clearance and the Oberhausen-clearance ranged from r = 0.96 to r = 0.97, the Excretion-clearance (differential-method) correlated with r = 0.90. The absolute difference of the clearance-values was lowest comparing the Bubeck-clearance with the Sapirstein-clearance with an average difference of 11%, whereas the Excretion-clearance revealed at least an average difference of 21% and the Oberhausen-clearance of 24%.

The Excretion-clearance requires a more complicated protocol measuring the clearance in comparison to the Bubeck-clearance. The results of the excretion-clearance differ more from the Sapirstein-clearance with regard to the examined patient population than the Bubeck-clearance. Regarding the theoretical basis of the methods, we expect advantages of the Excretion-clearance compared with the Bubeck-Clearance in patients with compartmental disproportion or with a low clearance. We are going to prove this in combination with the above mentioned methodical improvements in a further study.