THE PREDICTIVE VALUE OF131I-HIPPURATE CLEARANCE IN THE PROGNOSIS OF ACUTE RENAL FAILURE

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Abstract
The aim of this investigation was to study the validity ofthe radionuclide methods in the estimation of kidney function, for prognosisand follow-up of acute renal failure (ARF). In thirty-one ARF patients, theevaluation of glomerular filtration rate (GFR) by 99mTc-DTPAclearance and effective renal plasma flow (ERPF) by 131I-ortoiodohippurate(131I-OIH) clearance was performed within 7 daysand after 6 months from ARF onset. All patients were divided in three groupsaccording to 131I-OIH clearance values obtainedwithin 7 days: group 1, under 150 mL/min; group 2, 150–250 mL/min; andgroup 3, over 250 mL/min. Seven days clearance values of both radiopharmaceuticalswere found to be very low, however, GFR was found more severely impaired thanERPF. Clearance values obtained after 6 months demonstrated no recovery ofrenal function in the first group, partial recovery in the second and almostcomplete recovery in the third group. Patients with the lowest 131I-OIHclearance values at the ARF onset had no recovery of renal function, whilein the other two groups recovery corresponded to initial 131I-OIHclearance values. In patients with ARF both, 99mTc-DTPAand 131I-OIH clearances were shown suitable forthe follow up of renal function, however, only 131I-OIHclearance had a strong predictive prognostic value for renal function recoveryin ARF.