Download PDF
Der Nuklearmediziner 2003; 26(3): 169-180
DOI: 10.1055/s-2003-44329
Nuklearmedizinische Nierendiagnostik

© Georg Thieme Verlag Stuttgart · New York

Methoden zur quantitativen Clearancebestimmung

Clearance Determination MethodsB. Bubeck1
  • 1Klinik für Nuklearmedizin, Kantonsspital St. Gallen, Schweiz
Further Information

Publication History

Publication Date:
20 November 2003 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Es gibt mehrere Prinzipien, nach denen Clearancebestimmungen durchgeführt werden können und unter diesen jeweils eine Reihe von unterschiedlichen Verfahren, die teilweise in Abhängigkeit vom verwendeten Radiopharmakon zur Anwendung kommen. Insbesondere für einfache und häufig in der klinischen Routine eingesetzte Methoden stehen eine Vielzahl verschiedener, empirisch gefundener Algorithmen zur Verfügung, über deren Wertigkeit und Genauigkeit sich die Experten selten einig sind und die länderabhängig in unterschiedlichem Ausmaß eingesetzt werden.
In der vorliegende Arbeit werden zum einen die physiologischen Grundlagen von Clearancebestimmungen erörtert sowie die vorwiegend eingesetzten Radiopharmaka vorgestellt, zum anderen die theoretischen Hintergründe der einzelnen Clearancebestimmungsverfahren dargelegt. Schwerpunktmäßig befasst sich der Artikel dabei mit der Modifikation der seit Anfang der 70-iger Jahre bekannten Single-Sample-Methode durch den Autor. Die resultierenden neuen Algorithmen sind inzwischen vor allem in Deutschland sehr verbreitet, was als wesentlicher Beitrag zur Standardisierung von Clearanceergebnissen mit 99mTc-MAG3 anzusehen ist. Außerdem wird eine Auswahl geeigneter Algorithmen für die Verwendung verschiedener Clearancesubstanzen präsentiert.
Ergänzend erfolgt eine detaillierte Beschreibung eines ganz wesentlichen Teils der nuklearmedizinischen Nierendiagnostik: Die Berechnung der seitengetrennten, relativen Clearance nach einer Methode, die in die Software der meisten Kamerahersteller implementiert ist.

Abstract

There are several principles which can be used for clearance determination, and a number of different methods are applied under each principle, some of them dependent on the radiopharmaceutical used. A large variety of different algorithms, which were determined empirically, are available for methods employed in clinical routine. Experts seldom agree on their usefulness and accuracy, and they are employed to different extents depending on the country.
This review article presents the physiological basics of clearance determination and gives a short overview of the radiopharmaceuticals used as well as showing the theoretical background of the respective clearance determination methods. The paper focuses on the author's modification of the single-sample method, which has been known since the 1970's. The resulting new algorithms are meanwhile widely used especially in Germany, which is a considerable contribution to the standardization of clearance results using 99mTc-MAG3. Furthermore, a selection of suitable algorithms for the use of different clearance substances is offered.
A further, essential aspect of renal diagnostics in nuclear medicine is described in detail: The calculation of the split clearance using a method implemented in the software of most camera manufacturers.

Schlüsselwörter

Nierenfunktion - Clearance - GFR - ERPF - TER

Key words

Renal function - clearance - GFR - ERPF - TER

Literatur

  • 1 Assailly J, Pavel D G, Bader C, Chanard J, Ryerson T W, Cotard J-P, Funck-Brentano J L. Noninvasive experimental determination of the individual kidney filtration fraction by means of a dual-tracer technique.  J Nucl Med. 1977;  18 684-691
    PubMedGoogle Scholar
  • 2 Bianchi C, Toni P. The measurement of the renal clearance of gamma-emitting tracers by the use of external counting.  Experientia. 1964;  20 148-149
    PubMedGoogle Scholar
  • 3 Blaufox M D. Procedures of choice in renal nuclear medicine.  J Nucl Med. 1991;  32 1301-1309
    PubMedGoogle Scholar
  • 4 Blaufox M D, Aurell M, Bubeck B, Fommei E, Piepsz A, Russell C, Taylor A, Thomsen H S, Volterrani D. Report of the radionuclides in nephrourology committee on renal clearance.  J Nucl Med. 1996;  37 1883-1890
    PubMedGoogle Scholar
  • 5 Blaufox M D, Frohmüller H GW, Campbell J C, Utz D C, Orvis A L, Owen C A. A simplified method of estimating renal function with iodohippurate I131.  J Surg Res. 1963;  3 122-125
    PubMedGoogle Scholar
  • 6 Blaufox M D, Merrill J P. Simplified hippuran clearance. Measurement of renal function in man with simplified hippuran clearances.  Nephron. 1966;  3 274-281
    PubMedGoogle Scholar
  • 7 Blaufox M D, Potchen E J, Merrill J P. Measurement of effective renal plasma flow in man by external counting methods.  J Nucl Med. 1967;  8 77-85
    PubMedGoogle Scholar
  • 8 Boer P. Estimated lean body mass as an index for normalization of body fluid volumes in humans.  Am J Physiol. 1984;  247 632-636
    PubMedGoogle Scholar
  • 9 Brøchner-Mortensen J, Giese J, Rossing N. Renal inulin clearance versus total plasma clearance of 51Cr-EDTA.  Scand J Clin Lab Invest. 1969;  23 301-305
    PubMedGoogle Scholar
  • 10 Bubeck B. Renal clearance determination with one blood sample: Improved accuracy and universal applicability by a new calculation principle.  Semin Nucl Med. 1993;  23 73-86
    CrossrefPubMedGoogle Scholar
  • 11 Bubeck B. Technetium-99m-MAG3 für die nuklearmedizinische Nierenfunktionsdiagnostik. Pharmakokinetik und klinische Anwendung im Vergleich mit radiojodierter Hippursäure (2. Auflage). Hans Huber, Bern 1993
    Google Scholar
  • 12 Bubeck B. Bestimmung der Nierenclearance mit einer Blutentnahme.  Der Nuklearmediziner. 1994;  17 35-46
    PubMedGoogle Scholar
  • 13 Bubeck B, Brandau W, Eisenhut M, Weidenhammer K, Georgi P. The tubular extraction rate (TER) of Tc-99m MAG3: A new quantitative parameter of renal function.  NucCompact. 1987;  18 260-267
    PubMedGoogle Scholar
  • 14 Bubeck B, Brandau W, Weber E, Kälble T, Parekh N, Georgi P. Pharmacokinetics of technetium-99m-MAG3 in humans.  J Nucl Med. 1990;  31 1285-1293
    PubMedGoogle Scholar
  • 15 Bubeck B, Brandau W, Weber E, Pomer S, Georgi P, zum Winkel K. Renal function studies using 99mTc-MAG3: Pharmacokinetics and slope clearance determination. In: Blaufox MD, Hollenberg NK, Raynaud C (eds). Radionuclides in Nephro-Urology. Karger, Basel. Contrib Nephrol 1990; 79: 72-73
    Google Scholar
  • 16 Bubeck B, Piepenburg R, Grethe U, Ehrig B, Hahn K. A new principle to normalize plasma concentrations allowing single-sample-clearance determinations in both children and adults.  Eur J Nucl Med. 1992;  19 511-516
    PubMedGoogle Scholar
  • 17 Carlsen J L, Møller M L, Lund J O, Trap-Jensen J. Comparison of four commercial Tc-99m(Sn)DTPA preparations used for the measurement of glomerular filtration rate: Concise communication.  J Nucl Med. 1980;  21 126-129
    PubMedGoogle Scholar
  • 18 Chantler C, Garnett E S, Parsons V, Veall N. Glomerular filtration rate measurement in man by the single injection method using 51Cr-EDTA.  Clin Sci. 1969;  37 169-180
    PubMedGoogle Scholar
  • 19 Constable A R, Hussein M M, Albrecht M P, Thompson F D, Philalithis P E, Joekes A M. Single sample extimates of renal clearances.  Br J Urol. 1979;  51 84-87
    PubMedGoogle Scholar
  • 20 Dakubu S, Adu D, Nkrumah K N, Anim-Addo Y, Belcher E H. Single blood sample estimation of glomerular filtration rate.  Nucl Med Commun. 1980;  1 83-86
    PubMedGoogle Scholar
  • 21 Dissmann T, Gotzen R, Neuber K, Offermann B, Schwab M. Das Erythrocyten- und Plasmavolumen sowie die Relation zwischen Körperhämatokrit und venösem Hämatokrit in verschiedenen Stadien der essentiellen und bei renovasculärer Hypertonie.  Klin Wschr. 1971;  49 915-927
    CrossrefPubMedGoogle Scholar
  • 22 Doppelfeld E. Untersuchungen zur 131J-Hippuran-Clearance bei der Stauungsniere. Die Extraktion von Para-Amino-Hippursäure und 131J-Hippuran in der akut gestauten Hundeniere.  Nucl-Med. 1979;  18 181-185
    PubMedGoogle Scholar
  • 23 DuBois D, DuBois E F. Clinical calorimetry. X. A formula to estimate the approximate surface area if hight and weight be known.  Arch Intern Med. 1916;  17 863-891
    PubMedGoogle Scholar
  • 24 Fawer C L, Torrado A, Guignard J P. Maturation of renal function in full-term and premature neonates.  Helv Paediat Acta. 1979;  34 11-21
    PubMedGoogle Scholar
  • 25 Fine E J, Axelrod M, Gorkin J, Saleemi K, Blaufox M D. Measurement of effective renal plasma flow: A comparison of methods.  J Nucl Med. 1987;  28 1393-1400
    PubMedGoogle Scholar
  • 26 Fisher M, Veall N. Glomerular filtration rate estimation based on a single blood sample.  Br Med J. 1975;  2 542
    CrossrefPubMedGoogle Scholar
  • 27 Fleming J S, Wilkinson J, Oliver R M, Ackery D M, Blake G M, Waller D G. Comparison of radionuclide estimation of glomerular filtration rate using technetium 99m diethylenetriaminepentaacetic acid and chromium 51 ethylenediaminetetraacetic acid.  Eur J Nucl Med. 1991;  18 391-395
    PubMedGoogle Scholar
  • 28 Gates G F. Glomerular filtration rate: Estimation from fractional renal accumulation of 99mTc DTPA (stannous).  Am J Roentgenol. 1982;  138 565-570
    PubMedGoogle Scholar
  • 29 Gordon I, Anderson P J, Orton M, Evans K. Estimation of technetium-99m-MAG3 renal clearance in children: Two gamma camera techniques compared with multiple plasma samples.  J Nucl Med. 1991;  32 1704-1708
    PubMedGoogle Scholar
  • 30 Groth S, Aasted M. 51Cr-EDTA clearance determined by one plasma sample.  Clin Physiol. 1981;  1 417-425
    PubMedGoogle Scholar
  • 31 Groth T, Tengstrom B. A simple method for the determination of glomerular filtration rate.  Scand J Clin Lab Invest. 1977;  37 39-47
    PubMedGoogle Scholar
  • 32 Hagstam K E, Nordenfelt I, Svensson L, Svensson S E. Comparison of methods for determination of glomerular filtration rate in renal disease.  Scand J Clin Lab Invest. 1974;  34 31-36
    PubMedGoogle Scholar
  • 33 Hall J E, Guyton A C, Farr B M. A single-injection method for measuring glomerular filtration rate.  Am J Physiol. 1977;  232 72-76
    PubMedGoogle Scholar
  • 34 Ham H R, Piepsz A. Estimation of glomerular filtration rate in infants and in children using a single-plasma sample method.  J Nucl Med. 1991;  32 1294-1297
    PubMedGoogle Scholar
  • 35 Hamilton D, Miola U J. Body surface area correction in single-sample methods of glomerular filtration rate estimation.  Nucl Med Commun. 1999;  20 273-278
    PubMedGoogle Scholar
  • 36 Heidenreich P, Lauer O, Fendel H, Oberdorfer M, Pabst H W. Determination of total and individual kidney function in children by means of I-123-hippuran, whole body clearance and scintillation camera.  Pediatr Radiol. 1981;  11 17-27
    CrossrefPubMedGoogle Scholar
  • 37 Hör G, Kretschko J, Heidenreich P, Pabst H W, Kempken K, Schwarzendorfer A. Bestimmung der renalen Filtrationsfraktion durch simultane Doppelradionuklid-Clearancetechnik.  Fortschr Röntgenstr. 1974;  120 322-330
    PubMedGoogle Scholar
  • 38 Jackson J H, Blue P W, Ghaed N. Glomuerular filtration rate determined in conjunction with routine renal scanning.  Radiology. 1985;  154 203-205
    PubMedGoogle Scholar
  • 39 Jacobsson L. A method for the calculation of renal clearance based on a single plasma sample.  Clin Physiol. 1983;  3 297-305
    CrossrefPubMedGoogle Scholar
  • 40 Junges R. Nuklearmedizinische Bestimmung der Nierenclearanceäquivalent zur physiologischen Clearancemessung.  Fortschr Röntgenstr. 1983;  139 683-690
    PubMedGoogle Scholar
  • 41 Kinsman J M, Moore J W, Hamilton W F. Studies on the circulation. I. Injection method: Physical and mathematical considerations.  Am J Physiol. 1929;  89 322-330
    PubMedGoogle Scholar
  • 42 Lear J L, Feyerabend A, Gregory C. Two-compartment, two-sample technique for accurate estimation of effective renal plasma flow: Theoretical development and comparison with other methods.  Radiology. 1989;  172 431-436
    PubMedGoogle Scholar
  • 43 Lerson G, Delwaide P A, Lejeune G, Rorive G, Merchie G. The value of two simplified methods for the measurement of renal plasma flow by 131 I-hippuran. In: Blaufox MD, Funck-Brentano JL (eds). Radionuclides in Nephrology. Grune & Stratton, New York 1972; 241-247
    Google Scholar
  • 44 Möhring K, Georgi P, Röhl L, Sinn H. Simultaneous split measurement of glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) by 111-In-DTPA and 131-I-orthoiodohippurate-infusion clearance following initial double-isotope scintigraphy. In: zum Winkel K, Blaufox MD, Funck-Brentano JL (eds). Radionuclides in Nephrology. Georg Thieme, Stuttgart 1975; 309 -314
    Google Scholar
  • 45 Morgan W D, Birks J L, Sivyer A, Ghose R R. An efficient technique for the simultaneous estimation for GFR and ERPF, involving a single injection and two blood samples.  Int J Nucl Med Biol. 1977;  4 79-83
    CrossrefPubMedGoogle Scholar
  • 46 Mostbeck A. Quantitative Funktionsprüfung der Nieren auf Basis der Tiefenkorrektur und der frühen Hippuranakkumulation. In: Munkner T, Schmidt HAE (eds). Qualitätskriterien in der Nuklearmedizin. Schattauer, Stuttgart 1977; 345 -349
    Google Scholar
  • 47 Mulligan J S, Blue P W, Hasbargen J A. Methods for measuring GFR with technetium-99m-DTPA: An analysis of several common methods.  J Nucl Med. 1990;  31 1211-1219
    PubMedGoogle Scholar
  • 48 Nadler S B, Hidalgo J K, Block T. Prediction of blood in normal human adults.  Surgery. 1962;  51 224-232
    PubMedGoogle Scholar
  • 49 Oberhausen E, Kirsch W, Emrani I. Measurement of unilateral renal plasma flow by combination of clearance determination and renograms. In: Blaufox MD, Funck-Brentano JL (eds). Radionuclides in Nephrology. Grune & Stratton, New York 1972; 233-239
    Google Scholar
  • 50 Oberhausen E, Romahn A. Bestimmung der Nierenclearance durch externe Gammastrahlenmessung. In: Hoffmann G, Höfer R (Hrsg). Radionuklide in Kreislaufforschung und Kreislaufdiagnostik. Schattauer, Stuttgart 1968; 323-326
    Google Scholar
  • 51 Pedersen J F, Pedersen M F, Madsen P O. Clinical renal function testing by external double isotope monitoring technique.  Nucl-Med. 1971;  10 16-24
    PubMedGoogle Scholar
  • 52 Piepenburg R, Grimm W, Duempelfeld K M, Emmes S, Hahn K. Zwei vereinfachte Methoden zur simultanen Bestimmung von glomerulaerer Filtrationsrate (GFR) und effektivem renalem Plasmafluss (ERPF).  Nucl-Med. 1993;  32 103
    PubMedGoogle Scholar
  • 53 Piepsz A, Dobbeleir A, Erbsmann F. Measurement of separate kidney cleareance by means of 99mTc-DTPA complex and a scintillation camera.  Eur J Nucl Med. 1977;  2 173-177
    PubMedGoogle Scholar
  • 54 Piepsz A, Gordon I, Hahn K. Paediatric nuclear medicine.  Eur J Nucl Med. 1991;  18 41-66
    PubMedGoogle Scholar
  • 55 Piepsz A, Gordon I, Hahn K, Kolinska J, Kotzerke J, Sixt R. Determination of the technetium-99m mercaptoacetyltriglycine plasma clearance in children by means of a single blood sample: a multicentre study.  Eur J Nucl Med. 1993;  20 244-248
    PubMedGoogle Scholar
  • 56 Rehling M, Møller M L, Thamdrup B, Lund J O, Trap-Jensen J. Simultaneous measurement of renal clearance and plasma, clearance of Tc-99m labelled diethylenetriamine pentaacetate, Cr-51 labelled ethylenediamine tetraacetate and inulin in man.  Clin Sci. 1984;  66 613-619
    PubMedGoogle Scholar
  • 57 Rehling M, Nielsen L E. Plasma clearance of Tc-99m-MAG3: Accuracy of five single-sample methods.  Nucl Med Commun. 2000;  21 193-197
    CrossrefPubMedGoogle Scholar
  • 58 Retzlaff J A, Tauxe W N, Kiely J M, Stroebel C F. Erythrocyte volume, plasma volume, and lean body mass in adult men and women.  Blood. 1969;  33 649-661
    PubMedGoogle Scholar
  • 59 Rohloff R, Hast B, Leisner B, Heinze H G. Bestimmung der J-131-Hippuran-Clearance im Rahmen der Kamerafunktionsszintigraphie der Nieren nach vereinfachten Modifikationen der Methode von Oberhausen.  Nucl-Med. 1974;  13 303-320
    PubMedGoogle Scholar
  • 60 Russell C D. A comparison of methods for GFR measurement using Tc-99m-DTPA and the gamma camera. In: Tauxe WN, Dubovsky EV (eds). Nuclear Medicine in Clinical Urology and Nephrology. Appleton Century Crofts, New York 1985; 173-189
    Google Scholar
  • 61 Russell C D, Bischoff P G, Kontzen F N, Rowell K L, Yester M V, Lloyd L K, Tauxe W N, Dubovsky E V. Measurement of glomerular filtration rate: Single injection plasma clearance method without urine collection.  J Nucl Med. 1985;  26 1243-1247
    PubMedGoogle Scholar
  • 62 Russell C D, Bischoff P G, Rowell K L, Kontzen F, Lloyd L K, Tauxe W N, Dubovsky E V. Quality control of Tc-99m-DTPA for measurement of glomerular filtration.  J Nucl Med. 1983;  24 722-727
    PubMedGoogle Scholar
  • 63 Russell C D, Dubovsky E V. Measurements of renal function with radionuclides.  J Nucl Med. 1989;  30 2053-2057
    PubMedGoogle Scholar
  • 64 Russell C D, Dubovsky E V, Scott J W. Simplified methods for renal clearance in children: Scaling for patient size.  J Nucl Med. 1991;  32 1821-1825
    PubMedGoogle Scholar
  • 65 Russell C D, Dubovsky E V. Comparison of single-injection multisample renal clearance methods with and without urine collection.  J Nucl Med. 1995;  36 603-606
    PubMedGoogle Scholar
  • 66 Russell C D, Dubovsky E V. Reproducibility of single-sample clearance of Tc-99m-mercaptoacetyltriglycine and I-131-orthoiodohippurate.  J Nucl Med. 1999;  40 1122-1124
    PubMedGoogle Scholar
  • 67 Russell C D, Taylor A, Eshima D. Estimation of technetium-99m-MAG3 plasma clearance in adults from one or two blood samples.  J Nucl Med. 1989;  30 1955-1959
    PubMedGoogle Scholar
  • 68 Russell C D, Taylor A T, Dubovsky E V. Measurement of renal function with technetium-99m-MAG3 in children and adults.  J Nucl Med. 1996;  37 588-593
    PubMedGoogle Scholar
  • 69 Sapirstein L A, Vidt D G, Mandel M J, Hanusek G. Volumes of distribution and clearances of intravenously injected creatinine in the dog.  Am J Physiol. 1955;  181 330-336
    PubMedGoogle Scholar
  • 70 Schlegel J U, Hamway S A. Individual renal plasma flow determination in 2 minutes.  J Urol. 1976;  116 282-285
    PubMedGoogle Scholar
  • 71 Scholz A, Meinig K H, Oeff K. Clearance-Bestimmungen bei konstantem Blut- und Gewebsspiegel mit strahlungsgesteuerter Infusionspumpe.  Strahlentherapie. 1967;  65 (Sonderband) 467-474
    PubMedGoogle Scholar
  • 72 Shore R M. Glomerular filtration rate in children: Where we have been; where we are going.  J Nucl Med. 1991;  32 1297-1300
    PubMedGoogle Scholar
  • 73 Summerville D A, Potter C S, Treves S T. The use of radiopharmaceuticals in the measurement of glomerular filtration rate: A review. In: Freeman LM (ed). Nuclear Medicine Annual. Raven Press, New York 1990; 191-221
    Google Scholar
  • 74 Tauxe W N. Determination of glomerular filtration rate by single-plasma sampling technique following injection of radioiodinated diatrizoate.  J Nucl Med. 1986;  27 45-50
    PubMedGoogle Scholar
  • 75 Tauxe W N, Bagchi A, Tepe P G, Krishnaiah P R. Single-sample method for the estimation of glomerular filtration rate in children.  J Nucl Med. 1987;  28 366-371
    PubMedGoogle Scholar
  • 76 Tauxe W N, Dubovsky E V, Kidd T E. Comparison of measurement of effective renal plasma flow by single sample and plasma disappearance slope/volume methods.  Eur J Nucl Med. 1984;  9 443-445
    PubMedGoogle Scholar
  • 77 Tauxe W N, Dubovsky E V, Kidd T, Diaz F, Smith L R. New formulas for the calculation of effective renal plasma flow.  Eur J Nucl Med. 1982;  7 51-54
    PubMedGoogle Scholar
  • 78 Tauxe W N, Hagge W, Stickler G B. Estimation of effective renal plasma flow in children by use of a single plasma sample after injection of orthoiodohippurate. In: IAEA (ed). Dynamic Studies with Radioisotopes in Medicine (Vol I). International Atomic Energy Agency, Vienna 1975; 264 -275
    Google Scholar
  • 79 Tauxe W N, Maher F T, Taylor W F. Effective renal plasma flow: Estimation from theoretical volumes of distribution of intravenously injected 131I-orthoiodohippurate.  Mayo Clin Proc. 1971;  46 524-531
    PubMedGoogle Scholar
  • 80 Taylor A, Corrigan P L, Galt J, Garcia E V, Folks R, Jones M, Manatunga A, Eshima D. Measuring technetium-99m-MAG3 clearance with an improved camera-based method.  J Nucl Med. 1995;  36 1689-1695
    PubMedGoogle Scholar
  • 81 Taylor A, Eshima D, Fritzberg A R, Christian P E, Kasina S. Comparison of iodine-131 OIH and technetium-99m MAG3 renal imaging in volunteers.  J Nucl Med. 1986;  27 795-803
    PubMedGoogle Scholar
  • 82 Taylor A, Lewis C, Giacometti A, Hall E C, Barefield K P. Improved formulars for the estimation of renal depth in adults.  J Nucl Med. 1993;  34 1766-1769
    PubMedGoogle Scholar
  • 83 Tepe P G, Tauxe W N, Bagchi A, Rezende P, Krishnaiah P R. Comparison of measurement of glomerular filtration rate by single sample, plasma disappearance slope/intercept and other methods.  Eur J Med. 1987;  13 28-31
    PubMedGoogle Scholar
  • 84 Tondeur M, Kinthaert J, Piepsz A, Ham H R. Overall accuracy of technetium-99m-MAG3 clearance measurements obtained with a gamma camera heart curve.  J Nucl Med. 1996;  37 1281-1284
    PubMedGoogle Scholar
  • 85 Tønnesen K H, Munck O, Hald T, Mogensen P, Wolf H. Influence on the radiorenogram of variation in skin to kidney distance and the clinical importance hereof. In: zum Winkel K, Blaufox MD, Funck-Brentano J-L (eds). Radionuclides in Nephrology. Georg Thieme, Stuttgart 1975; 79-86
    Google Scholar
  • 86 Watson W S. A simple method of estimating glomerular filtration rate.  Eur J Nucl Med. 1992;  19 827
    PubMedGoogle Scholar
  • 87 Wenting G J, Tan-Tjiong H L, Derkx F HM, de Bruyn J HB, Man in't Veld A J, Schalekamp M ADH. Split renal function after captopril in unilateral renal artery stenosis.  Br Med J. 1984;  288 886-890
    PubMedGoogle Scholar
  • 88 White A J, Strydom W J. Normalisation of glomerular filtration rate measurements.  Eur J Med. 1991;  18 385-390
    PubMedGoogle Scholar
  • 89 Russell C D. A Bayesian 3-compartment model for 99mTc-MAG3 clearance.  J Nucl Med. 2003;  44 1357-1361
    PubMedGoogle Scholar

1 Bezugsquelle von PC-Programmen zur Clearenceberechnung nach dieser Methode siehe unter „Hinweise” am Ende dieses Artikels.

Prof. Dr. B Bubeck

Klinik für Nuklearmedizin

Kantonsspital St. Gallen

CH-9007 St. Gallen

Schweiz

Phone: +41-71/4 94-22 82

Fax: +41-71/4 94-63 65

Email: bernd.bubeck@kssg.ch

      >