COMPARATIVE EVALUATION OF UROGRAPHIC CONTRAST MEDIA, INULIN, AND 99mTc-DTPA CLEARANCE METHODS FOR DETERMINATION OF GLOMERULAR FILTRATION RATE IN CLINICAL TRANSPLANTATION

Lewis, Richard M.; Kerr, N. A.; Buren, C. Van; Lowry, Patricia A.; Sandler, Carl M.; Frazier, O. H.; Powers, Penny; Herson, Jay; Corriere, Joseph N.; Kerman, Ronald H.; Kahan, Barry D.

doi:10.1097/00007890-198911000-00013

Cited by 73 publications

(40 citation statements)

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“…A further useful marker for individual GFR assessment is the iodinated contrast agent iohexol (Lewis et al 1989). There are some disadvantages related to the use of this agent such as the risks of iodine allergies and anaphylaxis which limit the use of iohexol.…”

Section: Contrast Medium As a Markermentioning

confidence: 99%

Accurate measurement of individual glomerular filtration rate in cancer patients: an ongoing challenge

Holweger

Bokemeyer

Lipp

2005

J Cancer Res Clin Oncol

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A narrow therapeutic index is a characteristic feature of cytotoxic agents. Some of these agents are almost entirely eliminated renally in unchanged active form. As a consequence, assessment of the individual glomerular filtration rate (GFR) may help to predict the pharmacokinetic behaviour of cytotoxic agents in plasma more precisely. In addition, GFR-adapted individualization of cancer chemotherapy may have an enormous impact on the severity of side effects. Several methods are available to determine GFR or creatinine clearance (CrCl). GFR-measurement based on experimental methods with radiolabelled isotopes, contrast media or inulin helps to reflect the real situation very closely. In addition, 24-h urine collection is a convenient and feasible method to measure creatinine clearance. Finally, several mathematical equations exist to estimate GFR or CrCl based on serum creatinine and other parameters. Only a few of these equations have been developed in oncologic patients. However, some of these equations are routinely used in clinical practice, because they allow a rapid estimation of GFR. Based on the fact that clinically relevant differences have been assessed between calculated values and the real situation, mathematical calculation of GFR or CrCl does not seem to be appropriate to assess individual renal function precisely enough over a broad range of individual GFR or CrCl. Whether the measurement of low-molecular-weight proteins, such as cystatin C and ss-trace protein, may help to reflect the real situation more precisely is a matter of controversial debate.

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Section: Contrast Medium As a Markermentioning

confidence: 99%

Accurate measurement of individual glomerular filtration rate in cancer patients: an ongoing challenge

Holweger

Bokemeyer

Lipp

2005

J Cancer Res Clin Oncol

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“…Hence, the limits of agreement were -17 ml min-' 1.73 m-2 and 23 ml min-' 1.73 m-2, respectively. Lewis et al (1989) found r = 0.86 for X-ray contrast clearance and inulin clearance measurements. From their tabulated data (Lewis et al, 1989, Table I) the mean difference between the methods was 0.7 ml min' 1.73 m2, with standard deviation 17.7 ml min-' 1.73 m2.…”

Section: Discussionmentioning

confidence: 93%

Glomerular filtration rate, 131I-hippuran clearance and estimated creatinine clearance in cancer patients

Lindegaard

Aass²,

Bue³

et al. 1991

Br J Cancer

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Summary Glomerular filtration rate (GFR), '3'I-Hippuran clearance and estimated creatinine clearance were investigated in 34 patients with cancer. For Hippuran clearance and GFR, analysed with the X-ray contrast (iohexol) and fluorescence technique, the least square linear regression coefficient was 5.01 ± 0.41 (r = 0.91). This value concurs with the five to one ratio between GFR and renal plasma flow known from normal physiology and supports that Hippuran clearance is a valid measure of renal function. When the individual values of Hippuran clearance were divided by 5.01, the mean difference between the methods was 0.4 ml min' 1.73 m2 with standard deviation 13.4 ml min-' 1.73 m2. The lower and upper limits of agreement were -26.7 and 25.9 ml min-' 1.73 m2, respectively. Comparing creatinine clearance estimated from the serum creatinine level with GFR, the limits of agreement were -29.4 and 21.6 ml min-' 1.73 m-2. These agreement limits are in the same range as those which can be calculated from the data from other studies.

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“…GFR was measured using urinary iothalamate clearance for equation derivation at the Mayo Clinic (2) and by plasma 99m Tc-DTPA clearance in the current study. Mounting evidence suggests that the various mGFR measurement techniques are not interchangeable and that they, too, have an inherent measurement uncertainty associated with their performance (25)(26)(27). A lack of improvement in performance of the creatinine-based MDRD study equation with calibration was also reported by Stevens et al in over half of the studies included in an analysis of 10 different research and clinical populations (28), which could be attributed to either or a combination of differences in measurement technique or of residual bias inherent to calibration efforts.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Interlaboratory Differences in Cystatin C Assay Measurement on Glomerular Filtration Rate Estimation

White¹,

Rule²,

Collier³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Cystatin C (CysC) is a promising marker of GFR. Several equations have been derived to estimate GFR from its serum concentration. Heterogeneity in the performance of these equations exists in validation studies even when the same CysC assay from the same manufacturer is utilized. This study was designed to examine the differences in CysC and GFR estimation (eGFR) using Siemens' nephelometric immunoassay and the Mayo Clinic equation. The ability of the eGFRs to predict measured GFR was also examined.Design, setting, participants, & measurements Ninety-seven split samples were sent to laboratories at Children's Hospital of Eastern Ontario (CHEO) in Ottawa, Canada, and at the Mayo Clinic in Rochester, Minnesota. ResultsThe mean CHEO CysC was 0.17 mg/L (10%) lower than the mean Mayo Clinic CysC. Using the Mayo Clinic equation, the mean eGFR difference was 7.2 ml/min per 1.73 m 2 (15%). Approximately 36% of the results agreed within 10%, while 13% were discordant by greater than 30%. Larger absolute differences in mean eGFR between the two laboratories were found in the subgroup with CysC less than 1.41 mg/L as compared with the subgroup greater than 1.41 mg/L (9.5 versus 5.0 ml/min per 1.73 m 2 ). Correction of CHEO values to the Mayo Clinic did not improve GFR estimation. Conclusions Significant differences in CysC measurement exist between laboratories using the same assay by the same manufacturer and these lead to clinically relevant differences in GFR estimation. This interlaboratory variability needs to be recognized when interpreting and comparing CysC and eGFR results.

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COMPARATIVE EVALUATION OF UROGRAPHIC CONTRAST MEDIA, INULIN, AND 99mTc-DTPA CLEARANCE METHODS FOR DETERMINATION OF GLOMERULAR FILTRATION RATE IN CLINICAL TRANSPLANTATION

Cited by 73 publications

References 0 publications

Accurate measurement of individual glomerular filtration rate in cancer patients: an ongoing challenge

Accurate measurement of individual glomerular filtration rate in cancer patients: an ongoing challenge

Glomerular filtration rate, 131I-hippuran clearance and estimated creatinine clearance in cancer patients

The Impact of Interlaboratory Differences in Cystatin C Assay Measurement on Glomerular Filtration Rate Estimation

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