Limitations of clearance determination using the single sample distribution volume method

Abstract

To investigate the error possibly contained in the single sample distribution volume method for the determination of renal clearance, a mathematical model was applied to describe the effect of changes in distribution volume, clearance, intravascular space, intracompartmental exchange and the time point of blood sampling. The method was found to be valid only under well-defined circumstances (Topt = 45 +/- 5 min, Cl = 390 +/- 50 ml/min, Vd = 16.7 +/- 4 l, alpha = 0.05.V1 ml/min, V1/Vd = 0.5 +/- 0.05) as shown in sample calculations. Two-compartment model-based error calculations demonstrate that this technique implies at best an uncertainty of +/- 10% or more. Whilst it can be used preferably in healthy, normal-weight adults, it is not applicable, without error, under all other circumstances.

Error analysis of one sample clearance methods

“…The interesting error analysis of one-sample clearance methods by Kotzerke et al (1992) should not obscure the fact that the errors are small when compared with other methods for measuring renal function that are in widespread clinical use, such as creatinine clearance or blood-free gamma-camera methods.…”

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Error analysis of one sample clearence methods

Dear Sir,The interesting error analysis of one-sample clearance methods by Kotzerke et al (1992) should not obscure the fact that the errors are small when compared with other methods for measuring renal function that are in widespread clinical use, such as creatinine clearance or blood-free gamma-camera methods.The first single-injection, single-sample method of which we are aware was described by Alestig, H o o d and Vikgren (1966) using unlabelled inulin. A one-sample method using radiolabelled orthoiodohippurate (OIH) was described by Heiskanen, Weber and Graesbeck (1968).

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“…A one-sample method using radiolabelled orthoiodohippurate (OIH) was described by Heiskanen, Weber and Graesbeck (1968). The method of Tauxe, discussed at length by Kotzerke et al (1992), followed in 1971. Since then m a n y similar papers have appeared (our files contain 27 such papers) using not only these agents but also chromium-51 ethylene diamine tetra-acetic acid (EDTA), ytterbium-169 diethylene triamine penta-acetic acid (DTPA), technetium-99m DTPA, iodine-131 diatrizoate and 99mTc mercaptoacetyl triglycine (MAG3).…”

Error analysis of one sample clearence methods

“…Dubovsky proves that there is continuous interest in methodological questions relating to the clearance technique with radioactive and other substances -a subject the authors have only recently written about (Russel et al 1991). The aim of our own article was to show the marginal conditions of the single-sample clearance technique in order to differentiate between critical and less important influences and to permit a theoretical estimation of the range of errors occurring (Kotzerke et al 1992). The fact that the single-sample technique is associated with the name " T a u x e " (even though several other people have also worked with this method) is a phenomenon similar to the fact that in Germany renal function is often determined according to the "Oberhausen method", which is mostly unknown abroad (Oberhausen 1985).…”