Comparison of glomerular filtration rate estimation by 99mTc-DTPA to the reference radiotracer 51Cr-EDTA compared to methods based on blood creatinine measurement

Since the end of 2018, the distribution of the reference tracer for the measurement of glomerular filtration rate (GFR), the 51Cr-EDTA, is no longer provided by radiopharmaceutical companies around the world. In this study, we propose to compare the measurement of glomerular filtration rate by 99mTc-DTPA to that by 51Cr-EDTA. A double estimation of GFR by plasma clearance was performed in 12 patients, 10 of which were referred for GFR calculation prior to possible kidney donation. Linear regression coefficients and intraclass correlation coefficient (ICC) were calculated for the GFR measurement by 99mTc-DTPA, and by MDRD, CKD-EPI and Cockcroft and Gault formulas, relative to the 51Cr-EDTA measurement. The clearance measurement with 99mTc-DTPA is on average 7.25 [2.00; 14.96] mL/min/1.73m(2) higher than that of 51Cr-EDTA. The GFR measurement with 99mTc-DTPA showed a trend towards better agreement with the 51Cr-EDTA measurement in terms of linear regression parameters, but also in terms of ICC compared to the MDRD, CKD-EPI and Cockcroft and Gault methods. In conclusion, our study supports the use of the 99mTc-DTPA tracer in place of 51Cr-EDTA and shows a higher reliability compared to methods based on blood creatinine measurement. (C) 2021 Elsevier Masson SAS. All rights reserved.