title: Glomerular filtration rate measured by (99m) Tc-DTPA renal dynamic imaging is significantly lower than that estimated by the CKD-EPI equation in horseshoe kidney patients.
abstract: OBJECTIVE
  Gate's glomerular filtration rate (gGFR) measured by (99m) Tc-DTPA renal dynamic imaging and estimated GFR (eGFR) estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation are two indexes used to evaluate renal function. However, little is known about whether gGFR can be used to accurately assess renal function in horseshoe kidney (HSK) patients with renal fusion anomalies.
  
  
  METHODS
  Nineteen HSK patients (HSK group) diagnosed by renal imaging and 38 CKD patients with "normal kidney shape" (non-HSK group) matched to the HSK patients in terms of gender, age and biochemical indicators at Chinese PLA General Hospital were enrolled in this study. Gender, age, serum total protein (TP), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (Scr), gGFR and eGFR were recorded and analyzed using χ(2) test, t-test, and Wilcoxon test which was presented as median(IQR).
  
  
  RESULTS
  (1) There were no significant differences in gender, age, TP, ALB, BUN, Scr, or eGFR between these two groups. (2) In HSK patients, the renogram showed abnormal renal axis with the lower poles orientated medially. The timed uptake curve showed that the isotope excretion in the HSK group was slower than that in the non-HSK group. (3) For all HSK patients, gGFR was significantly lower than eGFR (range -12.52 mL/min per 1.73m(2) to -93.18 mL/min per 1.73m(2) ). There was no significant difference in eGFR between the HSK [96.42 (36.02) mL/min per 1.73 m(2) ] and non-HSK groups [94.46 (33.00) mL/min per 1.73 m(2) ]. The gGFR of the HSK group [41.18 (16.60) mL/min per 1.73m(2) ] was much lower than that of the non-HSK group [86.42(26.40) mL/min per 1.73m(2) , P < 0.001] and the eGFR of the HSK group (P < 0.001). The gGFR and eGFR of the non-HSK group were not significantly different.
  
  
  CONCLUSIONS
  gGFR measured by (99m) Tc-DTPA renal dynamic imaging is significantly lower than eGFR estimated by the CKD-EPI equation, which indicates that isotope renogram cannot accurately evaluate the GFR of HSK patients.
authors.affiliation: Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, City.
authors.forename: Yan
authors.initials: Y
authors.lastname: Qi
authors.affiliation: Department of Nephrology, Civil Aviation General Hospital, Beijing, City.
authors.forename: Panpan
authors.initials: P
authors.lastname: Hu
authors.affiliation: Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, City.
authors.forename: Yuansheng
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, City.|Medical College, Nankai University, Tianjin, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Wei
authors.affiliation: Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, City.|Medical College, Nankai University, Tianjin, China.
authors.forename: Meiling
authors.initials: M
authors.lastname: Jin
authors.affiliation: Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, China.
authors.forename: Guangyu
authors.initials: G
authors.lastname: Ma
authors.affiliation: Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, City.
authors.forename: Qinggang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, China.
authors.forename: Baixuan
authors.initials: B
authors.lastname: Xu
authors.affiliation: Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing, City.
authors.forename: Xiangmei
authors.initials: X
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D016009:Chi-Square Distribution; D002681:China; D003404:Creatinine / Q000097:blood; D005260:Female; D000069337:Fused Kidney / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005919:Glomerular Filtration Rate; D006769:Hospitals, General; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D011866:Radioisotope Renography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D016284:Technetium Tc 99m Pentetate / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: C422455:ALB protein, human; D015415:Biomarkers; D019275:Radiopharmaceuticals; D012709:Serum Albumin; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate; D000075462:Serum Albumin, Human
keywords: CKD-EPI equation; glomerular filtration rate; horseshoe kidney; renal dynamic imaging