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Year:
2013
| Volume: 21
| Issue: 3-4
| Pages: 146-150
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Special Article |
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ACCURATE ASSESSMENT OF RENAL FUNCTION PRIOR AND AFTER PEPTIDE RECEPTOR RADIONUCLIDE THERAPY
Branislava Ilincic, Zoran Stošic, Velibor Cabarkapa, Radmila Žeravica, Romana Mijovic |
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DOI:
https://doi.org/10.2298/AOO1304146I
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Abstract: |
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Peptide receptor radiation therapy (PRRT) with radiolabeled octreotide analogs is effective treatment in patients with
somatostatin receptor-positive neuroendocrine tumors. The kidneys are critical organ during PRRT because of peptide
reabsorption, retention, and prolonged irradiation in the proximal tubules. We presented results of kidney functions
tests in four patients before and after PRRT with 90Y-DOTATOC and 177Lu-DOTATATE, with special reference to the
pathophysiology of preexisting multiple risk factors for kidney impairment. We conducted several methods routinely
used in clinical practice to determine kidney function - serum creatinine, serum cystatin C, creatinine clearance (CrCl)
through 24 hours of urine collection and mathematical equations for prediction of glomerular filtration rate (GFR). A
very accurate measurement of kidney function (GFR and effective renal plasma flow) was done by radioactive tracers
- 99Tc- diethyl triamine pentaacetic acid and 131I ortho-iodohippurate plasma clearance. Beside PRRT nephrotoxicity,
patient age, preexisting kidney disease, and chronic comorbidities contribute to the risk of renal impairment. Because
clinically relevant differences were assessed between calculated values and the real situation, mathematical calculation
of GFR or CrCl did not seem to be appropriate to assess individual renal function precisely enough. |
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Key words:
Neuroendocrine Tumors; Kidney Function Tests; Glomerular Filtration Rate; Receptors, Peptide; Radiopharmaceuticals |
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