Iohexol clearance for GFR-determination in renal failure—single or multiple plasma sampling?

Abstract

The present study examined the agreement between single and multiple sample plasma clearance of iohexol, a non-ionic contrast agent, in renal failure. Sixty-five patients with varying degree of renal insufficiency received 10 ml iohexol (300 mg I/ml) i.v. and plasma samples were collected four times during the following 3-24 h. Plasma-iodine concentrations were determined by X-ray fluorescence. Predicted creatinine clearance was used to choose one of the samples for determination of single sample clearance. A single plasma specimen collected at 4 h for GFR above 50 ml/min, at 7 h for GFR between 20 and 50 ml/min, and at 24 h for GFR below 20 ml/min gave values in good agreement with those based on a four sample slope clearance. No sign of nephrotoxicity was noted after administration of the contrast agent. It is concluded that single sample plasma clearance after single injection of iohexol gives a good estimate of GFR in renal failure and is advantageous in clinical practice.

Cystatin C as a filtration marker – haemodialysis patients expose its strengths and limitations

“…The total coefficient of variation was 2.8 % and 3.8 % at S-albumin concentrations 23 g/L and 50 g/L, respectively. GFR was determined by measuring the plasma clearance of iohexol [20,21]. Serum iohexol concentrations were determined using a HPLC method.…”

Standardization of p‐creatinine assays and use of lean body mass allow improved prediction of calculated glomerular filtration rate in adults: A new equation

“…GFR was determined in all patients by measuring the plasma clearance of iohexol, a nonionic radiographic iodine contrast medium [23][24][25][26][27]; this is the present standard at both hospitals. Measurements of P-crea, weight and height, as well as age and gender, were recorded for all patients at the time of the examination.…”

Validation of a new plasma cystatin C-based formula and the Modification of Diet in Renal Disease creatinine-based formula for determination of glomerular filtration rate

“…Five millilitres of iohexol (Omnipaque † 300 mg I/ml; GE Healthcare, Stockholm, Sweden) was injected intravenously and clearance was calculated from the remaining iohexol concentration in one plasma sample [13,14]. The sampling time was determined from a calculated creatinine clearance [15]. Plasma iohexol levels were determined by high-pressure liquid chromatography [14].…”