Renal function in patients at risk of contrast material-induced acute renal failure: noninvasive, real-time monitoring.
Real-time changes in renal function were studied in a group of 20 patients at risk of contrast-material-induced acute renal failure during different angiographic procedures. Renal function was evaluated with an ambulatory renal monitor (ARM) after a single injection of the glomerular filtration agent technetium-99m diethylenetriaminepentaacetic acid (DTPA). The ARM was used to continuously monitor the clearance of Tc-99m DTPA activity from the extracellular space in the arm of the patient during angiography. A one-compartment model was used to calculate on-line the rate constant for clearance of Tc-99m DTPA from the extracellular space. Changes in the rate constant were compared with changes in plasma creatinine level measured 1-4 days after angiography. The results showed that the ARM measured rapid changes in renal function during angiography with a resolution time of 5-10 minutes in patients with normal to moderately decreased renal function and 15-20 minutes in patients with severe renal dysfunction. The sensitivity of this technique was superior to that of plasma creatinine level analysis.
Rabito
C A
CA
Department of Radiology, Massachusetts General Hospital, Boston 02114.
Fang
L S
LS
Waltman
A C
AC
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D000368:Aged; D000792:Angiography; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011877:Radionuclide Imaging; D051437:Renal Insufficiency / Q000150:complications; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016284:Technetium Tc 99m Pentetate
D003287:Contrast Media; D016284:Technetium Tc 99m Pentetate