Elimination of gadolinium-DTPA by peritoneal dialysis

Magnetic resonance urography (MRU) after i.v. injection of gadolinium-DTPA (0.1 mmol/kg bodyweight) was performed in a patient with transplant dysfunction after renal allograft transplantation. Renal replacement therapy was accomplished by means of peritoneal dialysis. Gadolinium-DTPA concentrations in urine and dialysate were measured repeatedly during a 48-h period with inductively coupled plasma atomic emission spectrometry. The total 24-h creatinine clearance was 10.8 ml/min on day 1 and 13.7 ml/min on day 2. The corresponding total gadolinium clearance was 12.8 ml/min and 15.8 ml/min respectively. Gadolinium-DTPA was removed from the body through peritoneal dialysis at a mean clearance rate of 5.13 ml/min. Plasma half-life of gadolinium-DTPA was prolonged to 9 h. No side-effects due to gadolinium-DTPA were noted. MRU provided a better visualization of the morphology of the urinary tract than scintigraphic studies. By measuring the changes of signal intensity, the gadolinium excretion could be calculated.