Assessing GFR in Elderly Patients [99mTc]-DTPA vs Creatinine-Based Methods

Introduction: Accurately measuring kidney function is essential, particularly in elderly patients, where traditional clinical formulas may not always be reliable. A recent study published in the Journal of Clinical Nephrology compares the gold-standard [99mTc]-DTPA method against common creatinine-based formulas to determine glomerular filtration rate (GFR) in patients aged 80 and above.

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Key Findings from the Study

• The study evaluated 47 patients (27 males, 20 females) with an average age of 81.9 years.
• GFR was calculated using four clinical formulas:
  • MDRD: 55.3% concordance with [99mTc]-DTPA
  • Cockroft-Gault: 55.3% concordance
  • CKD-EPI: 57.5% concordance
  • BIS-1: 51.1% concordance
• The CKD-EPI formula showed the highest agreement with [99mTc]-DTPA, whereas BIS-1 had the lowest concordance.
• The study confirmed that while clinical formulas provide estimates, [99mTc]-DTPA remains the most accurate method for measuring GFR in elderly patients.

Clinical Implications

• Accurate GFR assessment is crucial for diagnosing Chronic Kidney Disease (CKD) in the elderly.
• Overestimation or underestimation of GFR using clinical formulas can impact treatment decisions, especially when prescribing medications such as chemotherapeutic agents and anticoagulants.
• The study suggests integrating nuclear medicine-based renal scintigraphy with [99mTc]-DTPA for improved diagnostic accuracy in elderly populations.

External Expert Insights The National Kidney Foundation (NKF) highlights the importance of accurate GFR measurement in older adults, as creatinine-based formulas can be influenced by muscle mass, diet, and systemic diseases.

Where to Read More Read the full study at https://doi.org/10.29328/journal.jcn.1001096.

For related nephrology studies, explore our extensive research archive at https://www.clinnephrologyjournal.org/jcn.

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