title: Dynamic renal blood flow measurement by positron emission tomography in patients with CRF.
abstract: BACKGROUND
  Positron emission tomography (PET) is a functional imaging device that allows dynamic regional blood flow measurements. We performed a study to test whether PET could detect acute changes in renal blood flow (RBF) in patients with chronic renal failure (CRF).
  
  
  METHODS
  RBF was measured by means of PET (PET-RBF) using oxygen 15-labeled water (H2(15)O) in eight men with hypertension and moderate CRF before and 5, 40, 80, and 120 minutes after the injection of quinaprilat (10 mg intravenously). Effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) were measured simultaneously by para-aminohippuric acid (PAH-ERPF) and inulin clearances before and 20, 60, 100, and 140 minutes after quinaprilat injection.
  
  
  RESULTS
  Baseline RBF and ERPF were decreased in all patients (221 +/- 20 mL/min/100 g and 225 +/- 38 mL/min/1.73 m2, respectively). PET-RBF increased significantly after quinaprilat injection (+15%, +26%, +19%, and +23% versus baseline; P < 0.003). PAH-ERPF did not increase significantly (-6%, +12%, +20%, and +15% versus baseline; P = 0.15). GFR (50.1 +/- 8.9 mL/min/1.73 m2 at baseline) did not change significantly after quinaprilat injection; however, filtration fraction (GFR-ERPF ratio) decreased significantly from 0.23% +/- 0.02% to 0.20% +/- 0.02% (P = 0.0004). Mean arterial pressure decreased significantly after quinaprilat injection (P < 0.005).
  
  
  CONCLUSIONS
  This study dynamically measured RBF by means of PET in patients with CRF for the first time. It showed that RBF rapidly increased after quinaprilat injection. PET using H2(15)O is a powerful method for the noninvasive measurement of dynamic changes in RBF that remain undetected by PAH clearance.
authors.affiliation: Hospices Civils de Lyon, France. laurent.juillard@chu-lyon.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Juillard
authors.forename: Marc F
authors.initials: MF
authors.lastname: Janier
authors.forename: Denis
authors.initials: D
authors.lastname: Fouque
authors.forename: Luc
authors.initials: L
authors.lastname: Cinotti
authors.forename: Nora
authors.initials: N
authors.lastname: Maakel
authors.forename: Didier
authors.initials: D
authors.lastname: Le Bars
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Barthez
authors.forename: Nicole
authors.initials: N
authors.lastname: Pozet
authors.forename: Maurice
authors.initials: M
authors.lastname: Laville
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005919:Glomerular Filtration Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006626:Hippurates / Q000493:pharmacokinetics; D006801:Humans; D007444:Inulin / Q000493:pharmacokinetics; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D014055:Tomography, Emission-Computed / Q000379:methods*
chemical_list: D006626:Hippurates; D007444:Inulin