Renal handling of technetium-99m DMSA: evidence for glomerular filtration and peritubular uptake.
The finding of an enhanced excretion of [99mTc]dimercaptosuccinic acid (DMSA) in patients with tubular reabsorption disorders prompted us to investigate the role of filtration in the renal handling of [99mTc]DMSA. Our studies in human serum indicated that binding to serum proteins was approximately 90%. Chromatography of human urine and studies in rats showed that the complex was excreted unaltered into the urine. Renal extraction of [99mTc]DMSA in a human volunteer was 5.8%. Continuous infusion of [99mTc]DMSA in 13 individuals with normal renal function gave the following results (mean +/- s.d.): plasma clearance of [99mTc]DMSA 34 +/- 4 ml/min, urinary clearance of [99mTc]DMSA 12 +/- 3 ml/min. The calculated filtered load of [99mTc]DMSA closely resembled the urinary clearance, whereas the plasma clearance was about three times faster. This indicates that peritubular uptake accounts for approximately 65% and filtration for approximately 35% of the renal handling of [99mTc]DMSA.
de Lange
M J
MJ
Department of Nuclear Medicine, University Hospital, Groningen, The Netherlands.
Piers
D A
DA
Kosterink
J G
JG
van Luijk
W H
WH
Meijer
S
S
de Zeeuw
D
D
van der Hem
G K
GK
D000818:Animals; D001798:Blood Proteins / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000378:metabolism*; D007678:Kidney Glomerulus / Q000378:metabolism; D007684:Kidney Tubules / Q000378:metabolism; D009942:Organometallic Compounds / Q000493:pharmacokinetics* / Q000652:urine; D011485:Protein Binding; D011877:Radionuclide Imaging; D051381:Rats; D011919:Rats, Inbred Strains; D012079:Renal Circulation; D004113:Succimer / Q000493:pharmacokinetics* / Q000652:urine; D013438:Sulfhydryl Compounds / Q000493:pharmacokinetics*; D013667:Technetium / Q000493:pharmacokinetics / Q000652:urine; D019783:Technetium Tc 99m Dimercaptosuccinic Acid
D001798:Blood Proteins; D009942:Organometallic Compounds; D013438:Sulfhydryl Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013667:Technetium; D004113:Succimer