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A High-throughput Method for Measurement of Glomerular Filtration Rate in Conscious Mice
Published on: May 10, 2013
Glomerular filtration rate estimation by gamma camera technique using various methods of kidney depth measurement: A
Nithya Anandaram1, Anil Kumar Avs2, Inder Prakash Dubey1
1Army Hospital Research and Referral, New Delhi, India.
Background:
Renal scintigraphy using the 99m technetium-diethylene triamine pentaacetic acid [99mTc]Tc-DTPA Gates' protocol is widely employed for glomerular filtration rate (GFR) estimation. However, its accuracy is significantly influenced by the method used for renal depth estimation. This study systematically compared GFR estimation by Gates' protocol using three different depth correction techniques with the gold standard plasma sample analysis method.
Material And Methods:
[99mTc]Tc-DTPA renal scintigraphy was done as per standard protocol in 40 voluntary renal donors. Renal depth obtained by Tonnesen formula, lateral depth and computed tomography (CT) scan methods. Double plasma sample analysis was done simultaneously. GFR was calculated by Gates' protocol using the three methods of kidney depth measurement separately.
Results:
The mean total GFR, when measured using the gold standard plasma sample analysis, lateral depth, Tonnesen formula and CT scan, were 83.3 ± 22.34 mL/min, 90.7 ± 21.00 mL/min, 72.1 ± 19.85 mL/min and 89.8 ± 22.55 mL/min, respectively. The Pearson correlation coefficient demonstrated a positive correlation between plasma sample analysis and the 3 depth correction methods - lateral depth method (r = 0.524), Tonnesen formula (r = 0.697), and CT scan (r = 0.597). The intraclass correlation coefficient (ICC) - lateral depth method (ICC = 0.667), Tonnesen formula (ICC = 0.759), and CT method (ICC = 0.733) indicated varying levels of reliability. The Bland-Altman plot analysis revealed poor agreement - lateral depth technique (p = 0.033), Tonnesen formula (p < 0.001), and CT method (p = 0.049). Tonnesen formula exhibited a narrower distribution compared to the other two methods, with a spread of agreement of 64.97.
Conclusions:
The findings indicate that, while all three methods exhibited statistically significant variations from plasma sample-derived GFR, the Tonnesen formula showed the closest agreement, albeit with a tendency to underestimate GFR. In contrast, the lateral depth method and CT-derived renal depth consistently overestimated GFR, emphasising the variability introduced by different depth estimation techniques.
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