SST and kidney failure: These changes appear to be the consequence of megalin receptor saturation by the infusion of amino acids which reduce the uptake of [177Lu]-DOTA0-Tyr3-octreotate by proximal tubular cells, decrease renal irradiation, and therefore the risk of renal failure.[6] The metabolic pathway of megalin has been shown to be the primary determinant of somatostatin metabolic radiotherapy's nephrotoxicity.[9]