Evaluation of Glomerular Filtration Rate by Using Renal Scintigraphy

Abstract

The evaluation of glomerular filtration rate GFR by using renal Scintigraphy with enhancement of gamma camera system model (nucline spirit (DHV) variable angle dual head SPECT and whole body DH -503066-VO ) and Low energy general purpose collimator, has been carried out among 149 patients of multi renal diseases and 48 as a control group with age between 20-80 year . The obtained GFR was from an injection of the sample and control group by Tc-99m\DTPA as 185MBq (5mci). The collected data was the age versus GFR, weight versus GFR, height versus GFR and the normal GFR, in addition to the general distribution of the sample based on the gender. The study shows that: within the control group sample, the male represents 60.41% relative to the female who were representing 39.58%. Regarding GFR, the study reveals that: the predominant mean of GFR was 82.5 ml/min among the age group of 20-30 years old and the maximum GFR was 85.2 ml/min among the age group of 30-40 years old. While the age group of 40-50 years old have the lowest GFR which was 76.8 ml/min. The researchers also found that the relationship between the age and GFR is a inverse relationship i.e. as the age increases as the GFR decreases, such relationship was demonstrated by the following equation ( y  0.0393x  84.135 ), where y refer to GFR in ml/min and x refer to age in years. The results also reveal that the maximum mean of GFR is 86 ml/min, which is found among the weight group of 90-100 Kg, while the minimum GFR which is 81.5 ml/min was among the weight group of 40-50 Kg, indicating that the GFR increases as the weight increase. And the normal GFR among the Sudanese people in the range of 84 – 85.9 ml/min which fall in the range of standard GFR stated by Jacobsson et al, (1985) in which they found that the normal mean GFR was 84.75  16.63 ml/min. the general relationship between the weight and the GFR was deduced to be as follows: y  0.814x  81.8 where x refer to weight in Kg and y refer to GFR in ml/min. the study also shows that the common people encountered at hospitals complaining of renal problems were having the weight between 40-70 Kg. The analysis of the study also reveals that the height has a poor relationship with GFR that could be demonstrated in a form of the following equation y  0.2332x  122.43 where y refers to GFR and x refers to height, indicating that as the height increases the GFR increases. The ultimate goal of the study is that the normal GFR which has been determine by gamma camera method is 85.5  14.2 ml\min with an accuracy equal to 85.5% showing some advantages such as simple achieved accuracy, less time consuming, low radiation hazards, simplicity and non invasive method relative to Single Injection Two Plasma methods SITPM which determined by Jacobson in 1985 with an accuracy equal to 84.75  16.63 ml/min. The analysis of the data related to the multiple renal diseases patients, showed that most of the renal diseases were males and representing 57.04% relative to female. These multi renal diseases patients have predominant mean of GFR as 36.9 ml/min, while the age group of 20-30, 30-40 and 40-50 year old i.e. young adult having high average GFR at 43.27 ml/min and the other ages group having decreasing stepwise in GFR to be ended at the minimum GFR 33.4 ml/min and generally the results shows that the GFR fluctuating as high in the range of 40s ml/min then decrease with the age increment. The analyzed data also reveals that the maximum mean of GFR among multi renal diseases patients is 64.8 ml/min, which is found among the weight group of 110-120 Kg and the minimum GFR was 24 ml/min among the weight group of 20-30 Kg while the predominant mean of GFR was 43.2 ml/min among the weight group of 50-60 Kg. Generally the data showed that as the weight increase the GFR increases and this relation was expresses by the following equation: GFR  3.14w  25.1 where w refer to weight of the patient. The height of the patients also has a direct proportional relation with GFR which follows the following equation: GFR  3.75h  22.31 where h refer to the height of the patient.