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Effects of Dipyridamole Infusion on Human Renal Function Observed Using Technetium-99m-DTPA

Departments of Medicine and Nuclear Medicine & Magnetic Resonance, St. Joseph's Health Centre, Lawson Research Institute University of Western Ontario, London, Ontario, Canada

Correspondence: For reprints contact: Dr. Drank Prato, PhD, FCCPM, ABMP, Department of Nuclear Medicine & Magnetic Resonance, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, Canada N6A 4V2.

ABSTRACT

Our observation that a prolonged dipyridamole infusion reduced or eliminated blood clearance of Gd-DTPA in dogs led us to investigate if dipyridamole, infused intravenously at rates comparable to those used in thallium myocardial perfusion tests, would alter renal filtration in humans. Renal filtration was assessed using a bolus injection of 10 mCi of ^99mTc-DTPA in five males (19–63 yr old) with normal serum urea and creatinine. Twenty minutes following the bolus injection a 10-min intravenous infusion of either dipyndamole (0.14 mg/kg/min) or saline sham was given. Four to 10 min following the start of the dipyndamole infusion, a paradoxical rise in counts in the kidney region of interest was observed and persisted for 10 to 27 min. During this time, a 13% to 52% (mean±s.d., 40%±16%, p<0.007) reduction in the exponential slope defining the clearance of counts from the cardiac region of interest occurred (implying a reduction of glomerular filtration rate), mean heart rate increased 27±5 bpm, p<0.002 and mean diastolic pressure decreased 12.9±6.4 mmHg, p<0.028. This finding indicates that renal clearance of tracers such as thallium or contrast agents such as Gd-DTPA is reduced during dipyndamole infusion.