title: Nephrotoxicity after PRRT - still a serious clinical problem? Renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATATE and 90Y/177Lu-DOTATATE.
abstract: BACKGROUND
  The kidneys play an essential role in PRRT. The infusion of amino acids could reduce uptake in the kidney of radiolabelled peptides. The purpose of this study was to determine the extent of kidney damage post PRRT.
  
  
  METHODS
  53 patients, with disseminated neuroendocrine tumours (NET), received 3-5 cycles of up to a maximum 7.4 GBq/m2 calculated dose of 90Y-DOTATATE (n = 25) and 90Y/177Lu-DOTATATE (n = 28). Creatinine levels were measured and glomerular filtration rates (GFR) were calculated. A mixed amino acid infusion was used for nephroprotection.
  
  
  RESULTS
  Patients treated with 90Y-DOTATATE had a mean creatinine level of 0.77 ± 0.19 mg/dL and a mean GFR (mL/min/1.73 m2) of 103.6 ± 30.8. Patients treated with 90Y/177Lu-DOTATATE had a mean creatinine level of 0.92 ± 0.33 mg/dL and a mean GFR of 84.7 ± 26.3. In the follow up, among patients treated with 90Y-DOTATATE and 90Y/177Lu-DOTATATE, the mean GFR level at 12 months was 101.2 ± 31.3 v. 83.9 ± 25.2, at 24 months 80.2 ± 32.7 v. 77.2 ± 31.1, at 36 months 78.9 ± 42.1 v. 67.5 ± 9.7, and 48 months 59.7 ± 15.2 v. 72.6 ± 11.2. The mean yearly decrease in GFR was 4.5 mL in all treated patients; for patients treated with 90Y-DOTATATE and 90Y/177Lu-DOTATATE it was 6.8 v. 3.0, respectively.
  
  
  CONCLUSIONS
  90Y/177Lu-DOTATATE treatment induced statistically significantly less change in kidney function compared to 90Y-DOTATATE.
authors: Nuclear Medicine Department, Medical University of Warsaw, Banacha St. 1a,Warsaw, Poland. jolanta.kunikowska@wum.edu.pl
authors: Jolanta
authors: J
authors: Kunikowska
authors: Leszek
authors: L
authors: Królicki
authors: Anna
authors: A
authors: Sowa-Staszczak
authors: Dariusz
authors: D
authors: Pawlak
authors: Alicja
authors: A
authors: Hubalewska-Dydejczyk
authors: Renata
authors: R
authors: Mikołajczak
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000528:radiation effects*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000532:radiotherapy*; D015282:Octreotide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000209:etiology*; D015021:Yttrium Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: C539274:90Y-octreotate, DOTA(0)-Tyr(3)-Thr(8)-; D009942:Organometallic Compounds; D015021:Yttrium Radioisotopes; C447941:lutetium Lu 177 dotatate; D015282:Octreotide