Measurement of glomerular filtration rate in adults: accuracy of five single‐sample plasma clearance methods

Abstract

After an intravenous injection of a tracer that is removed from the body solely by filtration in the kidneys, the glomerular filtration rate (GFR) can be determined from its plasma clearance. The method requires a great number of blood samples but collection of urine is not needed. In the present investigation the total plasma clearance of 51Cr-EDTA (ethylenediaminetetra-acetate) was assessed from 13 blood samples taken 5-300 min post-injection in 44 adult patients with GFR greater than 15 ml min-1. In 34 of these patients the plasma clearance of 99Tcm-DTPA (diethylenetriaminepenta-acetate) was determined simultaneously. Using these clearance values as reference the accuracy of six simplified methods were studied: five single-sample methods and one five-sample method. The standard error of estimate (SEE) of the single-sample methods ranged from 4.2 to 7.5 ml min-1 using EDTA, and from 3.8 to 6.3 ml min-1 using DTPA. SEE of the five-samples method was 3.0 ml min-1 (EDTA) and 3.1 ml min-1 (DTPA). The single-sample methods given by Christensen & Groth (1986) and by Tauxe (1986) are recommended for daily use, as SEE was small even at low GFR values. In patients with GFR less than 80 ml min-1, in whom a highly accurate determination is needed, a multiple samples method is recommended, e.g., Brøchner-Mortensen (1972).

Reassessment of a classical single injection51Cr‐EDTA clearance method for determination of renal function in children and adults. Part II: Empirically determined relationships between total and one‐pool clearance

“…In all nine studies but one [22], the difference (Cl est 2Cl ref ) had been determined and was in each case found to be a little less than 0.0. The difference was significant in five of the studies [16,[18][19][20]23] and non-significant in three [3,17,21]. In six studies [16][17][18][19][20]22], the regression of Cl est on Cl ref was available, and at the upper level of Cl ref ranging from 110 to 176 mL/ min, the corresponding Cl est calculated from the regression equations underestimated Cl ref by 1.6 % to 8 % with a tendency to increase with increasing clearance level.…”

“…In nine studies on adults [3,[16][17][18][19][20][21][22][23], a comparison had been made of the total 51 Cr-EDTA plasma clearance determined from the full plasma concentration curve (Cl ref ), and estimated from a one-pool clearance using the BM before correction (Cl est ). No studies contained a corresponding comparison for children.…”

Do Healthy Potential Kidney Donors in India Have an Average Glomerular Filtration Rate of 81.4 ml/min?

“…The most accurate estimation of GFR using radiotracers involves determination of both the initial rapid and the late slow components of the plasma disappearance curve with multiple blood samples and analyzing the data either by the Stewart-Hamilton type formulation or by fitting the curve to two exponential terms [15]. These plasma bicompartmental models require 5–6 plasma samples.…”

Estimation of chromium-51 ethylene diamine tetra-acetic acid plasma clearance: a comparative assessment of simplified techniques

“…inaccuracy of 4.9%) among the methods tested. In spite of the fact that the method was implemented for use with diethylene triamine penta-acetic acid, correct results were obtained using EDTA, according to Rehling and Rab61 (1989).…”