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The Quantitation of the Renografin-Iodine-131 Renogram for Renal Clearance Determination¹

Winston-Salem, North Carolina

ABSTRACT

1. Although the Hipputope renovasculogram is perhaps easier to evaluate qualitatively by the uninitiated, with a moderate degree of experience, a similar order of accuracy can be achieved for the evaluation of a Renografin (¹³¹I) renogram.

2. The excretory phase of the Renografin (¹³¹I) renogram beyond the first five minutes can usually be expressed by a simple single exponential equation.

3. By utilizing this single exponential equation and the charted values in the excretory phase of the Renografin (¹³¹I) clearance can be calculated with an acceptable accuracy in a significant number of case, provided urine flow is maintained above 2 ml per minute. With the equation C = 2886 µ, where µ is the regression coefficient obtained from this single exponential equation, the Renografin (¹³¹I) clearance may be calculated with a p value of better than 0.01.

4. It has been demonstrated that both in the normal as well as in the abnormal state, Renografin (¹³¹I) clearance closely follows inulin clearance, and hence may be assumed to represent a good test for glomerular filtration (1,3).

5. It is our present opinion that our radioisotopic evaluation of renal function can readily include the following: (a) A Hipputope renogram particularly valuable for qualitative assay. (b) A Renografin (¹³¹I) renogram valuable not only for its qualitative assay of renal function, but also for a quantitative description of glomerular filtration. (c) A Renografin split-function, quantitated from the renogram, and from the combined Renografin (¹³¹I) clearance.

6. The Renografin (¹³¹I) clearance for each kidney is a test of glomerular filtration. It remains to be seen whether this split-function test is of value in the clinical evaluation of renovascular hypertension, and other clinical states.

FOOTNOTES

¹ Performed under U.S.P.H.S. N.I.H. 5418.

² Department of Radiology, Bowman Gray School of Medicine of Wake Forest College, Winston-Salem, North Carolina.