Glomerular filtration rate in relation to extracellular fluid volume: Similarity between99mTc-DTPA and inulin

Gunasekera, Ranjan; Allison, D J; Peters, A. M.

doi:10.1007/bf01736989

Cited by 41 publications

(31 citation statements)

References 18 publications

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“…It should be emphasized, however, that this does not invalidate the use of GFR/ECFV, as in this ratio P IOT falls out of the equation. For this reason, as also pointed out by others, assessment of GFR/ECFV is less sensitive to procedural errors than assessment of GFR alone (5,11). Third, this is a single-center study, investigating one tracer and one measurement protocol only.…”

Section: Discussionmentioning

confidence: 86%

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Feasibility and Impact of the Measurement of Extracellular Fluid Volume Simultaneous with GFR by 125I-Iothalamate

Visser¹,

Muntinga²,

Dierckx³

et al. 2008

Clinical Journal of the American Society of Nephrology

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The feasibility, validity, and possible applications of the assessment of extracellular fluid volume (ECFV) simultaneous with glomerular filtration rate (GFR) were assessed in a series of validation studies using the constant infusion method of 125 T he gold standard for measuring glomerular filtration rate (GFR) is by specific tracers, such as inulin, Cr-EDTA, iothalamate, and iohexol (1). Because the distribution volume (V d ) of these tracers for GFR ideally equal extracellular fluid volume (ECFV) (2-9), measuring GFR with such tracers could potentially be used for simultaneous assessment of ECFV.Simultaneously measuring ECFV and GFR has several advantages. First, it will allow better insight into the (patho)physiologic and clinical role of ECFV in renal disease and its complications, such as hypertension and left ventricular hypertrophy. Second, it has been proposed that the best way to normalize GFR between different individuals would be by ECFV rather than by body surface area (BSA) (6,10,11). Whereas normalizing GFR for ECFV would be attractive from a theoretical perspective, it has not gained acceptance in practice because it is considered too cumbersome (12). Validation of GFR measurement protocols for simultaneous assessment of ECFV would greatly increase the feasibility of normalizing GFR for ECFV.Various GFR tracers were used for measuring ECFV (2-9), but their validation, reproducibility, and calibration against a gold standard for ECFV are not well documented. In our center, accurate GFR measurement is performed as the clearance of 125 I-iothalamate (IOT) by the constant infusion method, simultaneously with the determination of effective renal plasma flow (ERPF) (13). This renal function measurement is used in topclinical care and for clinical research and allows estimating GFR with a day-to-day variability of only 2.5% (14). The aim of the current study was to validate this renal function protocol for assessing ECFV and to use the combined assessment for normalizing GFR to ECFV. To this purpose, we studied first, the agreement of V d IOT with V d of bromide, the golden standard for ECFV measurements, over a wide range of renal function. Second, we assessed the reproducibility of ECFV measurements by assessing V d IOT under conditions of standardized sodium intake in healthy volunteers. Third, in these volunteers we tested the sensitivity of V d IOT to detect a change in ECFV. Finally, we analyzed the impact of indexing GFR to ECFV in the above volunteers and in a cohort of 158 potential kidney donors. Materials and MethodsAll experiments were performed in adherence to the Declaration of Helsinki, approved by the Medical Ethics Committee of the University Medical Centre Groningen, and all participating subjects gave written informed consent for participation. Measurement of Renal FunctionRenal function measurements were performed using the constant infusion method with IOT and 131 I-Hippuran as described before (13-15). After drawing a time point-0 blood sample, a priming solution

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Section: Discussionmentioning

confidence: 86%

“…Because the distribution volume (V d ) of these tracers for GFR ideally equal extracellular fluid volume (ECFV) (2)(3)(4)(5)(6)(7)(8)(9), measuring GFR with such tracers could potentially be used for simultaneous assessment of ECFV.…”

mentioning

confidence: 99%

Feasibility and Impact of the Measurement of Extracellular Fluid Volume Simultaneous with GFR by 125I-Iothalamate

Visser¹,

Muntinga²,

Dierckx³

et al. 2008

Clinical Journal of the American Society of Nephrology

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“…The ECV, the actual fluid volume filtered by the kidney, should correlate Ž . with renal function Gunasekera et al, 1996 , andŽ . Pernia et al 1989 found this to be the case Ž 2 .…”

Section: Discussionmentioning

confidence: 99%

Renal function in suckling and fasting pups of the northern elephant seal

Houser

Crocker

Webb

et al. 2001

Comparative Biochemistry and Physiology Part A: Molecular &

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Elephant seals fast for prolonged periods without access to water. This is made possible, in part, by reductions in urine production. However, the mechanisms involved in reducing urine production are not understood. In this study, Ž . Ž . glomerular filtration rate GFR was measured in five northern elephant seal pups Mirounga angustirostris via the inulin clearance technique. Measurements were made during day 9 and day 18᎐22 of nursing and the second and eighth week of the postweaning fast. Plasma aldosterone and cortisol concentrations, quantified by radioimmunoassay, were measured in eight other weanlings during the second and eighth week of the fast. Mean GFR was 79.3" 29.3 mlrmin during the early suckling period and 78.2" 17.1, 89.8" 52.7, and 80.4" 12.2 mlrmin during the late suckling, early fasting and late fasting periods, respectively. Differences between nursing and fasting were insignificant, possibly because reduced protein oxidation during suckling and rapid recruitment of protein for tissue synthesis obviated the need for postprandial hyperfiltration. Alternatively, maintenance of GFR during fasting may facilitate urea concentration by compensating for reductions in the fractional excretion of urea. It is further hypothesized that aldosterone is primarily responsible for mediating renal water reabsorption in this system. ᮊ

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“…Measured Tc-99m DTPA serum clearance by multipleplasma sample method (MPSM) is similar to inulin clearance; however, it is not practical to collect multiple plasma samples on a daily routine (14). To facilitate the procedure, Tc-99m DTPA clearance by the two-plasma sample (TPS) method was compared to MPSM and a significant correlation was reported (15).…”

Section: Introductionmentioning

confidence: 99%

Comparison of glomerular filtration rate measurements with the two-plasma sample technique using Tc-99m DTPA and other methods in donor candidates for renal transplantation

et al. 2016

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Background/aim: Accurate measurement of glomerular filtration rate (GFR) in the evaluation of renal functions in potential kidney donors is associated with important outcomes for both the donor and recipient. We intended to determine the efficacy of various methods while estimating GFR in potential living kidney donors.Materials and methods: Fifty-three potential kidney donors (31 females, 22 males; mean age: 50.1 years) were included in this study. GFR was estimated simultaneously using the following methods: Gates' method, Cockcroft-Gault (CG) and modification of diet in renal disease (MDRD) prediction equations, and the two-plasma sample (TPS) technique. Using TPS as the reference method, the estimations of GFR with the other methods were compared with that of TPS.

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Glomerular filtration rate in relation to extracellular fluid volume: Similarity between99mTc-DTPA and inulin

Cited by 41 publications

References 18 publications

Feasibility and Impact of the Measurement of Extracellular Fluid Volume Simultaneous with GFR by 125I-Iothalamate

Feasibility and Impact of the Measurement of Extracellular Fluid Volume Simultaneous with GFR by 125I-Iothalamate

Renal function in suckling and fasting pups of the northern elephant seal

Comparison of glomerular filtration rate measurements with the two-plasma sample technique using Tc-99m DTPA and other methods in donor candidates for renal transplantation

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