Impact of body mass index on gates method of glomerular filtration rate estimation: A comparative study with single plasma sample method

Amit Nautiyal, Anirban Mukherjee, Deepanjan Mitra, Piyali Chatterjee, Anindya Roy

Indian Journal of Nuclear Medicine 2019 34(1):19-23

Purpose of the Study: This study aims to compare glomerular filtration rate (GFR) estimated by Gates method using gamma camera (GC) with single plasma sample method (SPSM) in people with normal and abnormal body mass index (BMI) using SPSM as gold standard. Materials and Methods: It was single-center prospective study including 60 voluntary kidney donors. Technetium-99m labeled Diethylene Triamine Pentaacetic Acid (99mTc-DTPA) was administered intravenous under GC. GFR was calculated using Gates Method. After the scan, the subjects were called again after 180 min of injection of 99m Tc-DTPA. Then, a 3 ml venous blood sample was obtained from the contralateral arm. Russell's formula was used to determine the GFR by SPSM. Results: Mean GFR calculated by SPSM and Gates' method, was 94.0 ± 15.2 ml/min/1.73 m2 and 87.3 ± 16 ml/min/1.73 m2 respectively. Moderate correlation noted between two methods (r = 0.71, P < 0.0001). Significant correlation noted between GFR calculated by SPSM and Gates method in people with normal BMI (r = 0.92) with no significant statistical difference (P = 0.8). However, only moderate correlation noted between GFR calculated by SPSM and Gates method in people with BMI outside normal range (r = 0.71) with a significant statistical difference (P = 0.0002). Conclusion: Gates method of GFR estimation using GC shows significant correlation with plasma sample technique in people with normal BMI. In people with BMI outside normal range, it significantly underestimates GFR.

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