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Prediction of renal function improvement in azotemic patients using glomerular filtration rate from 99mTc-DTPA renal scan: an observational study

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Abstract
Objective: This study aimed to evaluate the ratio of glomerular filtration rate (GFR) from 99mTc-DTPA dynamic renal scan (GFRSCAN) to estimated GFR (eGFR) as a predictor of renal function improvement in patients with azotemia.
Methods: A retrospective review of medical records was conducted to identify consecutive patients with newly discovered or aggravated azotemia who underwent 99mTc-DTPA renal scan. Significant renal function improvement was defined as ≥100% and ≥10 ml/min improvement of eGFR at 12 weeks compared to eGFR on the day of renal scan (eGFR0). The GFRSCAN/eGFR0 ratio was evaluated as a predictor of significant renal function improvement using logistic regression and receiver operating characteristic (ROC) curve analyses. Added value of the GFRSCAN/eGFR0 ratio in the prediction of significant renal function improvement were demonstrated by adjusting for best clinical predictor variables.
Results: The eligibility criteria were met by 224 patients, among whom 22 patients (9.8%) showed significant renal function improvement. The odds ratios of the GFRSCAN/eGFR0 ratio for predicting significant renal function improvement were 1.76 (95% confidence interval [CI]: 1.26?2.45, p<.001) in the univariable analysis and 1.70 (95% CI: 1.19?2.42, p=.003) after adjusting for clinical variables. The area under the ROC curve (AUC) of the GFRSCAN/eGFR0 ratio for predicting significant renal function improvement was 0.762 (95% CI: 0.648?0.871). The addition of the GFRSCAN/eGFR0 ratio to the best clinical prediction model raised the AUC from 0.726 to 0.794, and this increment was statistically significant (p=.02).
Conclusion: The GFRSCAN/eGFR ratio can predict renal function improvement in patients with azotemia. Future prospective studies are necessary to validate its potential clinical utilities.
Author(s)
김효상신형수유훈이효상
Issued Date
2021
Type
Article
Keyword
azotemiadiethylenetriamine-pentaacetic acidglomerular filtration raterenal function improvement
DOI
10.1097/MD.0000000000028332
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7441
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2614230028&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Prediction%20of%20renal%20function%20improvement%20in%20azotemic%20patients%20using%20glomerular%20filtration%20rate%20from%2099mTc-DTPA%20renal%20scan:%20an%20observational%20study&amp;offset=0&amp;pcAvailability=true
Publisher
MEDICINE
Location
미국
Language
영어
ISSN
0025-7974
Citation Volume
100
Citation Number
51
Citation Start Page
1
Citation End Page
8
Appears in Collections:
Medicine > Medicine
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