Technetium-99m mercaptoacetyltriglycine clearance: reference values for infants and children

Area of Science:

• Pediatric Nephrology
• Nuclear Medicine
• Renal Physiology

Background:

• Renal function assessment in children is crucial for diagnosing and managing kidney diseases.
• Technetium-99m mercaptoacetyltriglycine (99mTc-MAG 3) scintigraphy is a common tool for evaluating pediatric renal function.
• Establishing normative data for 99mTc-MAG 3 clearance in children is essential for accurate interpretation.

Purpose of the Study:

• To retrospectively analyze 99mTc-MAG 3 clearance data from a large cohort of pediatric patients.
• To determine the normal range of 99mTc-MAG 3 clearance in children across different age groups.
• To identify developmental trends in renal clearance during early childhood.

Main Methods:

• Retrospective analysis of 639 99mTc-MAG 3 clearance studies in children aged 7 days to 19 years.
• Standardized protocols included parenteral hydration, weight-based radiotracer dosage, and Bubeck et al. clearance calculation.
• A subset of 169 children with normal renal function was defined by strict criteria including GFR, tubular function, parenchyma, obstruction, reflux, and split function.

Main Results:

• 99mTc-MAG 3 clearance values demonstrated a progressive increase during the first months of life in infants.
• Pediatric renal clearance values reached the normal range observed in older children and adults between 7 and 12 months of age.
• The study established age-specific normative data for 99mTc-MAG 3 clearance in the pediatric population.

Conclusions:

• 99mTc-MAG 3 clearance is a valuable indicator of renal function maturation in infants and children.
• The findings provide essential reference ranges for diagnosing renal abnormalities in pediatric patients.
• This study contributes to the standardization and interpretation of pediatric renal scintigraphy.