Evaluation of skeletal muscle metabolism and response to erythropoietin treatment in patients with chronic renal failure using Tc-99(m)-sestamibi legscintigraphy

It is well known that uraemia affects skeletal muscle metabolism. This has been attributed to a variety of causes, including anaemia, vitamin D, carni tine deficiency and hyperparathyroidism. The aim of this study was to ascer tain whether Tc-99(m)-sestamibi leg scintigraphy is useful in the evaluatio n of skeletal muscle metabolism and the monitoring of treatment response in uraemic myopathy. Forty patients with chronic renal failure and 24 normal controls underwent examination. Fifteen patients with chronic renal failure received erythropoietin treatment. Tc-99(m)-sestamibi leg scintigraphy was performed in all subjects and in 15 patients after therapy. The calf-to-an kle uptake ratio was calculated by semi-quantitative analysis and normalize d to lean body mass. The normalized uptake ratios were significantly differ ent between patients and controls. After erythropoietin therapy, there was a significant increase in the normalized uptake ratios compared with pre-th erapy. Our results suggest that Tc-99(m)-sestamibi leg scintigraphy is usef ul in the assessment of muscle metabolic abnormalities and the effect of tr eatment in uraemic myopathy. ((C) 2000 Lippincott Williams & Wilkins).