Measuring glomerular filtration rate using 51Cr-EDTA

Pottel, Hans; Hoste, Liesbeth; Waele, Liesbeth De; Braat, Elke; Baete, Kristof; Goffin, Karolien; Levtchenko, Elena; Gheysens, Olivier

doi:10.1097/mnm.0000000000000186

Cited by 9 publications

(4 citation statements)

References 11 publications

(22 reference statements)

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“…1; Table 3,), as recently discussed by Pottel et al and Blake et al [29–31]. A significant difference and substantially lower performance was found when BSA normalization was done after the correction for the distribution phase; for example, the accuracy of BMadult after was clearly inferior to that of BMadult before ( p value of 0.002 for P10).…”

Section: Discussionsupporting

confidence: 65%

Iohexol plasma clearance in children: validation of multiple formulas and two-point sampling times

et al. 2016

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BackgroundIn children, estimated glomerular filtration rate (eGFR) methods are hampered by inaccuracy, hence there is an obvious need for safe, simplified, and accurate measured GFR (mGFR) methods. The aim of this study was to evaluate different formulas and determine the optimal sampling points for calculating mGFR based on iohexol clearance measurements on blood samples drawn at two time points (GFR2p).MethodsThe GFR of 96 children with different stages of chronic kidney disease (CKD) (median age 9.2 years, range 3 months to 17.5 years) was determined using the iohexol plasma clearance, with blood sampling at seven time points within 5 h (GFR7p) as the reference method. Median GFR7p was 65.9 (range 6.3–153) mL/min/1.73 m2. The performance of seven different formulas with early and late normalization to body surface area (BSA) was validated against the reference.ResultsThe highest percentage (95.8 %) of GFR2p within 10 % of the reference was calculated using the formula of Jødal and Brøchner–Mortensen (JBM) from 2009, with sampling at 2 and 5 h. Normalization to BSA before correction of the distribution phase improved the performance of the original Brøchner–Mortensen method from 1972; P10 of 92.7 % compared to P10 of 82.3 % with late normalization, and a similar result was obtained with other formulas.ConclusionsGFR2p performed well across a wide spectrum of GFR levels with the JBM formula. Several other formulas tested performed well provided that early BSA normalization was performed. Blood sampling at 2 and 5 h is recommended for an optimal GFR2p assessment.

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Section: Discussionsupporting

confidence: 65%

Iohexol plasma clearance in children: validation of multiple formulas and two-point sampling times

et al. 2016

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“…An outlier in a multiple sampling test is easier to handle, due to the removal of only 1 point after interpreting the elimination curve. The procedure for BSA normalization in the GFR calculation is also of high relevance, and the topic is discussed in several papers (206,207). The original Brøchner-Mortensen (BM) formula is based on BSA normalization after correction for the distribution phase, but the modified BM version for children is based on BSA normalization before correction for the distribution phase.…”

Section: The Best Way To Perform Single-point Mgfrmentioning

confidence: 99%

Estimating glomerular filtration rate in children: evaluation of creatinine- and cystatin C-based equations

et al. 2018

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“…Indexing GFR before or after the correction for the early compartment is debatable, even if the impact on the results is relevant only in the extreme body mass index (BMI) range. 17 , 18 Because body surface area indexation is considered in some models, 9 we decided to index all results before applying the correction. Urinary clearances were performed using local protocols with the following urine collections: Paris-Bichat: six 30-minute clearance periods; Créteil: six 30-minute clearance periods; Lyon: three to four 30-minute clearance periods; Malmö: two 60-minute clearance periods; Paris-Pompidou: six 30-minute clearance periods; and Kingston: three 60-minute clearance periods.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Plasma Clearance With Early-Compartment Correction Equations and Urinary Clearance in High GFR Ranges

Delanaye

Vidal‐Petiot

Stehlé

et al. 2021

Kidney International Reports

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Introduction: Glomerular filtration rate (GFR) is measured from the late plasma disappearance curve of an exogenous tracer, after correction for the early decay-corresponding to the distribution of the tracer-using various equations. These equations display the highest discrepancies in the GFR range above 90 ml/min per 1.73 m 2 , and their respective performances against a reference, urinary GFR measurement are unclear.Methods: In patients with mGFR >90 ml/min per 1.73 m 2 from 6 different cohorts, we compared GFR obtained from the plasma clearance of iohexol or 51 Cr-ethylenediamine tetraacetic acid (EDTA), after correction using Chantler (C), Bröchner-Mortensen (BM), Fleming (F), Jodal-Bröchner-Mortensen (JBM), and Ng (N) equations, with urinary clearance of the same tracers or inulin.Results: In 438 participants (median age 41 [39-42] years, 43% women), the median urinary clearance was 100.8 (94.7-112.6) ml/min per 1.73 m 2 . Plasma clearances using the correction equations were 105.7 (96.8-119.2), 102.4 (95.2-112.9), 100.7 (93.6-111.1), 102.6 (95.2-113.4), and 106.0 (98.2-117.6) ml/min per 1.73 m 2 for C, BM, F, JBM, and N, respectively. Concordance correlation coefficients between plasma and urinary clearances were poor for all equations. Compared with urinary clearances, BM, F, and JBM displayed the best accuracy within 10% (73%, 72%, and 71%, respectively, vs. 63% and 66% for C and N), whereas BM and JBM had the lowest median biases. Accuracy of all equations was especially low in the hyperfiltration range (urinary clearance >130 ml/min per 1.73 m 2 ). Conclusion:The BM and JBM equations displayed the best overall performances to correct for the early disappearance curve. Results of these equations should be interpreted with caution, especially in the highest GFR range.

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Measuring glomerular filtration rate using 51Cr-EDTA

Cited by 9 publications

References 11 publications

Iohexol plasma clearance in children: validation of multiple formulas and two-point sampling times

Iohexol plasma clearance in children: validation of multiple formulas and two-point sampling times

Estimating glomerular filtration rate in children: evaluation of creatinine- and cystatin C-based equations

Comparison of Plasma Clearance With Early-Compartment Correction Equations and Urinary Clearance in High GFR Ranges

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