Effect of 177Lu-oxodotreotide treatment on solitary kidney function

Overview

Objective: Assessment the risk of nephrotoxicity of ¹⁷⁷Lu-oxodotreotide in a patient with a solitary kidney and the impact on its functions.

Case report: A 75-year-old man after radical left-sided nephrectomy with chronic renal insufficiency in very slow progression (stage G3bA1) was indicated for treatment with ¹⁷⁷Lu-oxodotreotide for a generalized gastroenteropancreatic neuroendocrine tumor. ¹⁷⁷Lu-oxodotreotide is almost exclusively eliminated by the kidneys and together with the bone marrow they are considered as an organ at risk. There may be a higher risk of nephrotoxicity with ¹⁷⁷Lu-oxodotreotide treatment in patients with impaired renal function or with renal abnormalities and thus more frequent monitoring of renal function is recommended. Monitoring of serum creatinine concentration and calculated creatinine clearance using the Cockcroft and Gault formula reflecting glomerular function is recommended. As another criterion for evaluating kidney function, we chose the tubular extraction rate using the sample method according to Bubeck to assess the effect of treatment on tubular functions. Dosimetric measurement was an integral part of the course of therapy.

Keywords:

solitary kidney – well-differentiated neuroendocrine tumor – somatostatin receptors – 177Lu-oxodotreotide – Lutathera – renal insufficiency