In this study, the impact of ascites on clearance-based GFR estimation was examined by comparing GFR estimates from 99mTc-DTPA clearance and MR renography in cirrhosis patients with varying degrees of ascites. 99mTc-DTPA clearance significantly overestimated GFR relative to MR renography in patients with moderate-to-severe ascites, likely because of extra-renal clearance of tracer into abdominal ascites fluid. Conversely, MR renography was unaffected by the presence of ascites because it tracked uptake and excretion of tracer specifically by the kidneys. This ascites-insensitivity makes MR renography a promising technique for GFR assessment in cirrhosis patients, a population with a high incidence of ascites.
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