title: A new quantitative method for estimating glomerular filtration rate and its clinical value.
abstract: OBJECTIVE
  The estimation of the glomerular filtration rate (GFR) is essential for the renal function. However, all estimation methods for GFR have advantages and disadvantages. The aim of this study was to develop a new quantitative method for estimating GFR and evaluate its clinical value.
  
  
  METHODS
  The new GFR was estimated by quantifying the accumulation of Tc-99m DTPA in the dual kidneys and bladder during a gamma camera renogram study in 116 patients with chronic kidney disease. GFR was determined by this new method (nGFR), Gates' gamma camera technique (gGFR), a two-plasma sampling method (tGFR) and creatinine-based clearance as estimated by Cockcroft-Gault (cGFR) and abbreviated MDRD (aGFR) formulae. The correlation analysis, Bland-Altman analysis and receiver-operating characteristic (ROC) plots were carried out among above methods.
  
  
  RESULTS
  The nGFR value has significant correlation with tGRF (r = 0·827, P<0·01). The nGFR had the best overall performances with a lowest bias deviation (3·1 ml min(-1) /1·73 m(2) ), better precision (53·0 ml min(-1) /1·73 m(2) ), narrowest interquartile range (13·5 ml min(-1) /1·73 m(2) ) and best accuracy (68·1%) within 30% of the tGFR, compared with those of gGFR, cGFR and aGFR. The new method had the similar maximum accuracy with the Gates' method and creatinine clearance as estimated by Cockcroft-Gault and abbreviated modification of diet in renal disease (MDRD) method. The new method had better repeatability characteristic compared with the Gates' method.
  
  
  CONCLUSIONS
  The new method for estimating GFR had the better performances compared with the Gates' method and creatinine clearance as estimated by Cockcroft-Gault and MDRD method.
authors.affiliation: Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China.
authors.forename: Mu-Hua
authors.initials: MH
authors.lastname: Cheng
authors.affiliation: Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China.
authors.forename: Feng-Wei
authors.initials: FW
authors.lastname: Zeng
authors.affiliation: Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China.
authors.forename: Liang-Jun
authors.initials: LJ
authors.lastname: Xie
authors.affiliation: Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China.
authors.forename: Jian-Fang
authors.initials: JF
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, GuangZhou, Guangdong, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D015902:Gamma Cameras; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D011866:Radioisotope Renography / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D015203:Reproducibility of Results; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019275:Radiopharmaceuticals; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate
keywords: chronic kidney disease; creatinine clearance; glomerular filtration rate; radionuclide; renal dynamic imaging