Determination of Glomerular Filtration Rate by Gates' Method
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Determination of Glomerular Filtration Rate by Gates' Method
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Letters to the Editor Uncontrolled Variables in the Measurement of Renal Function TO THE EDITOR: Since posture,exercise, time of day, diet, and even emotional state have been reported to influence renal function (1,2), it has been suggested that renal function be measured only under conditions of bed rest (3). Ideally, clinical measurements should be made under standardized conditions. For example, pathologists know that the most reproducible blood chemistries are those drawn in bed before breakfast. Most nuclear medicine physicians have simply ig nored those aspects of patient preparation that are not easily controlled. However, as the methods of measuring renal func tion become more accurate, one might expect problems. We have recently encountered such a problem, which arose as follows. The routine renal function measurement in our clinic is a single-sample, single-injection effective renal plasma flow (ERPF) using hippuran. The ERPF is divided between the two kidneys in proportion to their uptake during the first 3 min to obtain separate values for each kidney. Before switching from an iodine-131 ("'I) radiopharmaceutical to another labeled with '-1!, we took the routine precaution of first comparing the new agent with the old. The results are shown in Fig. 1 (solid circles). To our surprise, there was an obvious difference between ERPF measured with ['"I]hippuran and that measured with ['-'IJhippuran (p
