Zur Messung der Nierenfunktion durch Clearancebestimmungen: Methoden und Indikationen – ein Update

Zusammenfassung

Um die Nierenfunktion quantitativ zu beurteilen, gibt es viele Methoden. Meist benützen die Kliniker die simple Bestimmung des Plasmakreatinins, einige wählen jedoch die Kreatininclearance mit Urinsammlungen und andere alternative, aber indirekte Verfahren. Die Isotopenclearancebestimmungen sind jedoch im Vergleich mit allen anderen Methoden einfach durchzuführen und ergeben eine hohe Genauigkeit bei äußerst geringer Strahlenexposition. In diesem Überblick werden der Clearancebegriff, die unterschiedlichen Radiopharmaka, deren Vor- und Nachteile, die unterschiedlichen Clearancetechniken sowie die klinischen Indikationen zu Clearanceuntersuchungen besprochen. Dabei handelt es sich um ein Update eines entsprechenden Artikels, der 2003 in „Der Nuklearmediziner” publiziert wurde.

Abstract

Renal function impairment can be monitored by many tests. Measurement of plasma-creatinine level is the most used method, 24 h plasma-creatininclearance with urine collection is used by others and also other alternative but indirect methods exist. However, the use of radionuclide-clearances is by far the easiest performed method with the highest accuracy and precision and gives very low irradiation dose. In the following we will discuss the different radiopharmaceuticals in use, their plus and minus, the different clearance methods in use, their limitations and give some clinically important indications to perform clearance investigations according to consensus reports. Summarizing the use of plasma clearance of 51-Cr-EDTA after a single injection with one blood sample can be generally recommended, however with some modifications in special clinical situations, which are pointed out. Please note, that this paper is, for a significant part, an update of a previous paper published 2003 in “Der Nuklearmediziner”

Schlüsselwörter

Clearance - GFR - ⁵¹Cr-EDTA - ^99mTc-MAG3

Key words

clearance - GFR - ⁵¹Cr-EDTA - ^99mTc-MAG3

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