Analyse of influence elements in the process of dynamic renal imaging to measure glomerular filtration rate and effective renal plasma flow in patients with type 2 diabetes mellitus

Objective: To detect the changes and clinical influence elements of radionuclide renal dynamic imaging to measure glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) in patients with type 2 diabetes mellitus (T2DM). Methods: One hundred and eight patients with T2DM were divided into 4 groups according to the values of urinary albumin excretion rate (UAER): Group I: UAER<20μg·min-1, 31 cases. Group II: UAER 20∼200μg·min-1, 28 cases. Group III: UAER >200μg·min-1, serum creatinine(SCr)<105μmol/L, 26 cases. Group IV: UAER>200μg·min-1, SCr≥ 105μmol/L, 23 cases. 99Tcm-diethylenetriamine pentaacetic acid and 99Tcm-ethylenedicysteine renal dynamic imaging were performed in all patients. GFR, ERPF and renogram were derived simultaneously. The levels of blood creatinine, blood urea nitrogen, urine albumin, blood press, fasting blood insulin, glycosylated hemoglobin, fasting blood glucousewere measured in the four groups. Results: With the evolvement of diabetes nephropathy (DN), UAERs were gradually ascended and the values of GFR and ERPF was gradually descended, the former offered remarkable inverse correlation with the two latters (r1= -0.497, P<0.05; r2=-0.215, P<0.05). The values of GFR and ERPF in four groups patients with hypertension was lower than without hypertension (t1=1.8, t2=2.1, t3=1.9, P<0.05; t4=3.2, P<0.01). Multielement stepwise regression analyses assumed that age, systolic pressure, glycosylated hemoglobin and insulin resistance index offered inverse correlation with GFR and ERPF (coefficient of regression factor: -0.507, -0.874, -0.528, -0.587, -0.336, -0.697, -0.348, -0.371, P<0.01). Conclusion: GFR and ERPF were sensitive index reflecting the changes of DN.Hypertension and insulin resistance were independence risk factors to make the value of GFR and ERPF decreased in patients with DN. (authors)