A new method to measure renal tubular degradation of small filtered proteins in man using radiolabelled aprotinin (Trasylol)

• Published in: Clinical science (1979) Vol. 83; no. 3; pp. 289 - 294
• Main Authors: RUSTOM, R, GRIME, S, MALTBY, P, STOCKDALE, H. R, CRITCHLEY, M, BONE, J. M
• Format: Journal Article
• Language: English
• Published: London Portland Press 01.09.1992
• Subjects: Aprotinin - blood; Aprotinin - pharmacokinetics; Aprotinin - urine; Biological and medical sciences; Chromatography, Gel; Chromatography, Paper; Humans; Iodine Radioisotopes; Kidney Diseases - metabolism; Kidney Tubules - metabolism; Medical sciences; Nephrology. Urinary tract diseases; Proteins - metabolism; Renal Dialysis; Technetium; Time Factors; Human; Proteins; Renal tubule; Urinary system disease; Renal function; Tubulopathy; Renal disease; Metabolism; Proteinuria
• ISSN: 0143-5221; 1470-8736
• DOI: 10.1042/cs0830289

1. A method has been developed to measure the renal tubular degradation of small filtered proteins in man using radiolabelled aprotinin (Trasylol), a 6500 Da cationic polypeptide. 2. Aprotinin (0.5 or 5.0 mg) was labelled with either 99mTc (40 MBq) or 131I (1 MBq) and injected intravenously in 19 renal patients (10 with normal renal function and nine on haemodialysis). Activity in plasma and urine was measured over 48 h, and chromatography with Sephadex-G-25-M was used to separate labelled aprotinin from free 99mTcO4- or 131I-. Renal uptake was measured for 99mTc-labelled aprotinin only. 3. The volumes of distribution were similar in all patients: 18.2 +/- 0.4 litres in those with normal renal function and 20.2 +/- 0.1 litres in the others. Chromatography showed all plasma activity as undegraded aprotinin and urine activity only as the free labels (99mTcO4- or 131I-). 4. In patients with normal renal function, activity in the kidneys rose rapidly to 24.2 +/- 2.8% of dose after 90 min and to 42.2 +/- 3.4% of dose after 24 h. In the dialysis patients, activity over the kidneys was only 2.7 +/- 0.8% of dose at 24 h. Extra-renal uptake was insignificant in all patients with normal kidney function. 5. Both 99mTcO4- and 131I- appeared in the urine promptly after injection, and the rates of excretion of the two isotopes were similar, varying little over 24 h (1.8 +/- 0.04% of dose/h and 1.7 +/- 0.04% of dose/h for 99mTc and 131I, respectively).