. This investigation was undertaken in order to determine whether the clearance of technetium-99m mercaptoacetyltriglycine (99mTc-MAG3) is more closely correlated to the clearance of
iodine-125 orthoiodohippurate (125I-OIH) than to the clearance of
chromium-51 ethylene diamine tetra-
acetate (51Cr-EDTA) and whether there is a clinically significant extrarenal clearance of
99mTc-MAG3 . Fifty-one patients with a glomerular filtration rate (GFR) of 4-132ml/min were studied. After a simultaneous single injection of the three tracers, plasma clearance was measured from blood samples 0-5h post injection (p.i.) (0-24h in patients with GFR<15ml/min). Renal plasma clearance was measured 0-5h p.i. The ratio between the renal plasma clearance of
99mTc-MAG3 and 125I-OIH was 0.57. The ratio between the renal plasma clearance of
99mTc-MAG3 and 51Cr-EDTA was 2.57. The coefficient of variation (CV) of the
99mTc-MAG3/125I-OIH ratio was significantly smaller than the CV of the
99mTc-MAG3/51Cr-
EDTA ratio (13.4% versus 31.2%). The corresponding plasma clearance ratios were 0.59 (CV=14.8%) and 2.48 (CV=27.0%). Plasma clearance overestimated renal plasma clearance by 7.0ml/min (5.4%) for
99mTc-MAG3 and by 4.1ml/min (8.4%) for 51Cr-EDTA. The difference in plasma and renal plasma clearance of 125I-OIH of 5.5ml/min did not reach statistical significance. Red blood cell binding of
99mTc-MAG3, 125I-OIH and 51Cr-EDTA was 2.0%, 14.6% and 0.2%, respectively. Protein binding of
99mTc-MAG3, 125I-OIH and 51Cr-EDTA was 86.3%, 61.1% and 5.9%, respectively. The volume of distribution of
99mTc-MAG3, 125I-OIH and 51Cr-EDTA was 16.3%, 27.0% and 19.4% of
body weight. In conclusion, the clearances of
99mTc-MAG3 and 125I-OIH are more closely correlated than is the clearance of
99mTc-MAG3 with GFR. Extrarenal clearance of
99mTc-MAG3 is relatively smaller than extrarenal clearance of 51Cr-EDTA. Thus, plasma clearance of
99mTc-MAG3 can be used as a measure of renal tubular function.