Evaluation of renal function in low-dose cyclosporine-treated patients using technetium-99m diaminocyclohexane: a cationic tubular excretion agent.
Technetium-99m diaminocyclohexane (DACH) is a new tubular agent excreted via a cationic transport mechanism, like cyclosporine-A (CsA). It is expected that 99mTc-DACH will permit effective assessment of tubular function in CsA-treated patients. To establish the pharmacokinetic characteristics of 99mTc-DACH and to ascertain whether this new agent is useful in CsA-treated patients, 11 healthy volunteers and 15 CsA-treated patients underwent renal imaging and clearance studies using 99mTc-DACH and chromium-51 ethylene diamine tetra-acetic acid (EDTA). 99mTc-DACH yielded satisfactory dynamic renal images in all participants. The mean plasma clearance of 99mTc-DACH was significantly greater than that of 51Cr-EDTA in volunteers (109.4¿19.7 ml/min versus 86.6 +/- 13.7 ml/min, P<0.05). However, the urinary excretion of 99mTc-DACH at 90 min was significantly lower than that of 51Cr-EDTA (46.1% +/- 9.3% versus 53.1% +/- 8.6%, P<0.05), most probably due to its partial parenchymal retention. The elimination half-life of 99mTc-DACH was significantly increased in CsA-treated patients in comparison to volunteers, and consequently the plasma clearance values were significantly suppressed in these patients, in contrast to 51Cr-EDTA and endogenous creatinine clearance values. In conclusion, our findings indicate that 99mTc-DACH, as a sensitive marker of cationic tubular function, could be used to monitor renal haemodynamics in patients receiving CsA treatment.
Sonmezoglu
K
K
Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
Erdil
T Y
TY
Demir
M
M
Sayman
H B
HB
Kabasakal
L
L
Yardi
O F
OF
Ozkara
H
H
Cem Mat
M
M
Solanki
K
K
Britton
K E
KE
D000293:Adolescent; D000328:Adult; D000368:Aged; D002412:Cations; D002860:Chromium Radioisotopes / Q000493:pharmacokinetics; D003514:Cyclohexylamines / Q000493:pharmacokinetics; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D004492:Edetic Acid / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics; D011866:Radioisotope Renography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics
D002412:Cations; D002860:Chromium Radioisotopes; D003514:Cyclohexylamines; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C084614:technetium Tc 99m diaminocyclohexane; D016572:Cyclosporine; D004492:Edetic Acid