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Technetium-99m-MAG₃ Clearance as a Parameter of Effective Renal Plasma Flow in Patients with Proteinuria and Lowered Serum Albumin Levels

Departments of Nuclear Medicine and Internal Medicine, University Hospital Groningen, The Netherlands

Correspondence: For reprints contact: R.A.M. Kengen, Department of Nuclear Medicine, University Hospital Groningen, Oostersingel 59, 9713 EZ Groningen, The Netherlands.

ABSTRACT

Although the renal clearance of ^99mTc-MAG₃ is about 60% of the ¹³¹I-hippurate clearance, ^99mTc-MAG₃ clearance may be useful to estimate ERPF. In one study, however, proteinuria seemed to influence the MAG₃/hippurate clearance ratio. In order to establish whether proteinuria or serum albumin level has influence on this ratio, a comparison was made between ^99mTc-MAG₃ clearance and ¹³¹I-hippurate clearance in 14 patients. There was a good linear correlation between MAG₃ and hippurate clearance, although the standard error of estimate of ERPF from MAG₃ was relatively large, which remained unexplained. No correlation was found between proteinuria and MAG₃/hippurate clearance ratio nor between serum albumin level, GFR, FF, ERPF and the MAG₃/hippurate clearance ratio. We therefore conclude that there is no correlation between proteinuria and albumin level and the MAG₃/hippurate ratio. A reasonable estimation of ERPF with MAG₃ can be made in patients with proteinuria and lowered serum albumin levels although the estimation may be less accurate.