Diagnostic Value Of Glomerular Filtration Rate In Patients With Diabetic Nephropathy With 99mTc-DTPA Renal Dynamic Imaging

Objective:To investigate the diagnostic value of glomerular filtration rate(GFR)and serum renal function parameters measured by 99mTc-DTPA renal dynamic imaging in diabetic nephropathy(DN).METHODS:Sixty-five patients with DKD admitted to our hospital from October 2015 to October 2017 were selected and classified into early nephropathy group(N:=21 cases)based on urinary albumin excretion rates(UAER)and clinical nephropathy.There were 23 patients in the group(N=21)and uremic group(N=23).Another 25 healthy subjects were selected as the control group.The GFR of each group was detected by 99mTc-DTPA renal dynamic imaging.Serum creatinine(SCr)was detected by sarcosine oxidase method and urea nitrogen(BUN)was measured by urease-glutamic acid dehydrogenase method.Immune nephelometry was used to detect cystatin C(Cysstatin C,CysC),and enzyme colorimetry was used to detect uric acid(UA).The clinical data of each group were analyzed,and the relationship between GFR and serum renal function was analyzed.Result:1.There was no significant difference in BMI between the DKD group and the control group.The uremia group had significant differences in BMI with the control group and the early nephropathy group.The systolic blood pressure in the clinical nephropathy group and the uremic group and the control group and early nephropathy There were statistically significant differences between the groups,and there were statistical differences between the three groups of DKD diastolic pressure and the control group.2.There were significant differences between SCr,BUN and UA in the clinical nephropathy group and the uremic group compared with the control group,and statistically significant difference with the diabetic group.There was a statistically significant difference between the renal disease group and the early nephropathy group;the total GFR of the DKD groups There was a significant difference in GFR between the left and right kidneys and the control group,and there was a statistically significant difference in GFR between the groups.There was a statistical difference between the GFR and diabetes groups in the clinical nephropathy group and the uremic group.The early nephropathy group and the diabetic group GFR.There was no significant difference;Cys C was significantly different from the control group,and it was statistically different from the diabetic group.There were statistical differences between the groups.3.GFR in DKD uremic group and clinical nephropathy group was significantly negatively correlated with serum renal function markers Scr,BUN,Cys C and UA;GFR was negatively correlated with Cys C:in early nephropathy group.4.The sensitivity of total GFR in early nephropathy group was 88.85 when the CUTOFF value was 88.85,95.2%,specificity was 84%.The sensitivity of total GFR in clinical nephropathy group was higher than other indexes when the CUTOFF value was 55,77,95.2%,specificity 100.%,the total GFR of the uremic group had a sensitivity of 95.7%and a specificity of 71.4%at a CUTOFF value of 30.39,but the sensitivity was lower than that of Scr.Conclusions:1.The glomerular filtration rate of 99mTc-DTPA renal dynamic imaging reflects renal function sensitivity and can detect early renal impairment of DN.2.99mTc-DTPA renal dynamic imaging method with glomerular filtration rate and serum renal function indicators has the advantage of early diagnosis,sensitivity is 95.6%when CUTOFF value is 88.85.