Comparison of Renal Blood Flow and Transit Times Measured by Means of 99mTc-Labelled Erythrocytes and Indocyanine Green in Humans with Normal and Diseased Kidneys

Abstract

1. In nineteen patients with normal or diseased kidneys, renal blood flow, transit times and vascular volume were determined by means of an indicator-dilution method. Two different indicators, plasma-bound Indocyanine Green (IG) and 99mTc-labelled erythrocytes, were used simultaneously. 2. Comparison of the results indicates that IG slightly overestimates renal blood flow, appearance time, mean transit time and vascular volume, as the erythrocyte/IG ratios averaged 0.972, 0.903, 0.93, and 0.921 respectively. Overestimation of the mean transit time was less apparent when it was prolonged. In patients with reduced renal function, the average blood flow values obtained with the two indicators were in good agreement. 3. It is unlikely that axial streaming of erythrocytes accounts for their shorter mean transit time, because the individual erythrocyte/IG mean transit time ratios were independent of the rate of blood flow and the peripheral packed cell volume. 4. Since the erythrocyte/IG mean transit time ratios correlated significantly with the erythrocyte/IG ratios for appearance time and renal blood flow, the common mechanism leading to a depression of all erythrocyte/IG ratios is presumably extravascular circulation and delayed recovery of a small fraction of IG.

Perfusion of the Residual Renal Cortex in Patients with Chronic Renal Disease

“…Studies utilizing clearance techniques, indi cator dilution and inert gas washout in patients with chronic renal parenchymal disease have all revealed a reduction in renal perfusion which parallels or somewhat exceeds the fall in glom erular filtration rate [2][3][4]9,II 15,17,[19][20][21][22][23][24][25][26][27][35][36][37][38][39]. This observation, in chronic glom erulonephritis, chronic pyelonephritis, diabetic glomerulosclerosis, polycystic kidney disease, scleroderma, advanced chronic renal allograft rejection and advanced nephrosclerosis sug gests a universal feature in chronic progressive renal failure.…”