ABSTRACTS PRESENTADOS AL 11th INTERNATIONAL SYMPOSIUM "RADIONUCLIDES IN NEPHRO-UROLOGY", REALIZADO EN MONTEREY, CALIFORNIA, 13-17 MAYO 2001.
6. GATES METHOD RE-EVALUATED IN A RETROSPECT1VE CLINICAL STUDY.
E.
Fommei, L. Mezzasalma, D. Volterrani, D. Bonora.
Institute of Clinical Physiology CNR, Depatment of Internal Medicine.
University of Pisa, Italy.
After
the implementation of central and peripheral computerized archives
in our Institute, we retrieved and revised 480 99mTc-DTPA renal radionuclide
studies. All of them had been processed according to the Gates method
for renal function evaluation, either as research or diagnostic investigations.
In the cases where they were available we also examined vital and
clinical parameters.
We tested the reproducibility of the method in our routine working
procedures: an optimal repeatability coefficient (following Bland
and Altman' method) has been found analyzing repeated measures of
GFR in a controlled study of a subgroup of subjects. Also an optimal
coefficient was found for both within- and between-observers variability.
GFR measures well correlated with vital or clinical parameters known
to be related to renal function either in health or diseases, such
as age, serum creatinine, blood pressure levels, albumin excretion
rate (p<0.01 for all of the regressions). In particular, we observed
a typical J shaped curve of regression between GFR and serum creatinine,
as expected from renal physiology (r=.66. p<0.001).
The application of the method to diagnostic tools such as ACEi or
diuretic renography allows the estimation of separate and global renal
function and its modifications with pharmacologic stimuli in the course
of routine renographic and scintigraphic evaluations.
It is known that the accuracy of Gates method as absolute GFR determination
is not optimal with respect lo reference clearance techniques. However,
its high reproducibility, particularly within-patients, makes it a
very useful tool to assess renal function on the short, medium and
long term follow-up.
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