A Novel Analysis Technique for Transcutaneous Measurement of Glomerular Filtration Rate With Ultralow Dose Marker Concentrations

Shmarlouski, Anatoli; Schock-Kusch, Daniel; Shulhevich, Yury; Buschmann, Volker; Röhlicke, Tino; Herdt, Deborah; Rädle, Matthias; Hesser, Jürgen; Stsepankou, Dzmitry

doi:10.1109/tbme.2015.2501544

Cited by 9 publications

(7 citation statements)

References 33 publications

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“…They show high potential to overcome most of the shortcomings of the standard GFR measurement techniques and routine GFR measurements also are expected in the near future in human beings. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] For laboratory use, the transcutaneous GFR ( t GFR) system (NIC-Kidney; Mannheim Pharma and Diagnostics GmbH, Mannheim, Germany), was optimized for the fluorescent GFR tracer fluorescein isothiocyanate (FITC)-sinistrin, which is commercially available. The NIC-Kidney system has been shown to be a reliable technique for GFR assessment in several animal models and species by various groups (a list of publications in which the NIC-Kidney system has been used is provided in the Supplementary Data section).…”

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confidence: 99%

Improved kinetic model for the transcutaneous measurement of glomerular filtration rate in experimental animals

Friedemann

Heinrich

Shulhevich

et al. 2016

Kidney International

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Transcutaneous measurement of the glomerular filtration rate (GFR) is now frequently used in animal studies. GFR allows consecutive measurements on the same animal, including multiple measurements on a daily basis, because no blood sampling is required. Here we derive and validate a novel kinetic model for the description of transcutaneously measured FITC-Sinistrin excretion kinetics. In contrast to standard 1- to 3-compartment models, our model covers the complete kinetic, including injection and distribution of the tracer in the plasma compartment. Because the model describes the complete progression of the measurement, it allows further refinement by correcting for baseline shifts observed occasionally during measurement. Possible reasons for shifts in the background signal include photo bleaching of the skin, autofluorescence, changes of physiological state of the animals during the measurements, or effects arising from the attachment of the measurement device. Using the new 3-compartment kinetic model with modulated baseline (GFR), GFR measurements in rats can reach comparable precision as those from GFR measurements assessed using a gold standard technique based on constant infusion of a tracer. Moreover, the variability of simultaneous (parallel) measurements, as well as repeatedGFR measurements in the same animals, showed higher precision when GFR was compared with the 1-compartment GFR model.

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confidence: 99%

Improved kinetic model for the transcutaneous measurement of glomerular filtration rate in experimental animals

Friedemann

Heinrich

Shulhevich

et al. 2016

Kidney International

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“…Transcutaneous measurements are known to have a significant challenge of overcoming background noises and signals resulting from skin reflection and auto fluorescence. An electronic apparatus put forth by Shmarlouski et al is based out of two concepts specifically designed to separate the desired and undesired signals: LTDM (lifetime-decomposition measurement) and TCSPC (time-correlated single-photon counting) [34]. The illumination is provided by a diode laser emitting at a wavelength of 485 nm.…”

Section: Non-invasive Measurement Techniquesmentioning

confidence: 99%

“…LTDM is based on the measurement of the fluorescence lifetime of the used GFR marker and it involves other components such as skin autofluorescence and reflection. For this reason, a specific statistical processing of the data is required to separate the signal from the background [34].…”

Section: Kinetic Models For the Calculation Of The Gfrmentioning

confidence: 99%

An overview of non-invasive methods for transcutaneous measurements of glomerular filtration

Yusuf

Picascia

Vajpayee

et al. 2021

Journal of Experimental Nephrology

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Chronic kidney disease (CKD) affects 10% of the population worldwide. It often leads to poor quality of life, especially among people suffering from end-stage CKD. Detection and treatment of the renal disorders at an early stage can help in postponing of end-stage disease as well as its treatment options, such as renal transplant and dialysis. The current routine measurement of glomerular filtration rate (GFR) includes methods that are expensive, cumbersome, time-consuming, inaccurate, often inconvenient and invasive for the patients. Non-invasive diagnostic techniques can help to overcome many of these drawbacks. This paper reviews the progress made in the field of transcutaneous GFR measurement as a way for a simpler, non-invasive, cheaper, and patient-friendly assessment of renal function. We have discussed the various markers designed in combination with different measurement devices for the measurement of GFR. Also, we have compared the different kinetic models used to study the marker's clearance from the plasma; which ultimately helps in calculating the GFR. Most of these techniques have been limited to pre-clinical studies until now, with promising results for their transition into clinical use in the near future.

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“…75,76 Pyrazine dyes have also been studied in rodent models to quantify a rate of clearance constant, and recent data indicate they have an adequate toxicity profile. 77 Finally, lifetime-decomposition measurements of FITC-sinistrin have been used to quantify GFR 66,78 and have allowed a reduction in FITC-sinistrin dose by factor of 200.…”

Section: Translating Fluorescence Measurements Into Clinical Observatmentioning

confidence: 99%

Rethinking CKD Evaluation: Should We Be Quantifying Basal or Stimulated GFR to Maximize Precision and Sensitivity?

Molitoris

2017

American Journal of Kidney Diseases

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Chronic kidney disease (CKD) remains an increasing clinical problem. Although clinical risk factors and biomarkers for development and progression of CKD have been identified, there is no commercial surveillance technology to definitively diagnose and quantify the severity and progressive loss of glomerular filtration rate (GFR) in CKD. This has limited the study of potential therapies to late stages of CKD when FDA-registerable events are more likely. Since patient outcomes, including the rate of CKD progression, correlate with disease severity, and effective therapy may require early intervention, being able to diagnose and stratify patients by their level of decreased kidney function early on is key for translational progress. In addition, renal reserve, defined as the increase in GFR following stimulation, may improve the quantification of GFR based solely on basal levels. Various groups are developing and characterizing optical measurement techniques utilizing new minimally invasive or non-invasive approaches for quantifying basal and stimulated kidney function. This development has the potential to allow widespread individualization of therapy at an earlier disease stage. Therefore, the purposes of this review are to suggest why quantifying stimulated GFR, by activating renal reserve, may be advantageous in patients and review fluorescent technologies to deliver patient-specific GFR.

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A Novel Analysis Technique for Transcutaneous Measurement of Glomerular Filtration Rate With Ultralow Dose Marker Concentrations

Cited by 9 publications

References 33 publications

Improved kinetic model for the transcutaneous measurement of glomerular filtration rate in experimental animals

Improved kinetic model for the transcutaneous measurement of glomerular filtration rate in experimental animals

An overview of non-invasive methods for transcutaneous measurements of glomerular filtration

Rethinking CKD Evaluation: Should We Be Quantifying Basal or Stimulated GFR to Maximize Precision and Sensitivity?

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