Methods of assessing renal function

Filler, Guido; Yasin, Abeer; Medeiros-Domingo, Mara

doi:10.1007/s00467-013-2426-7

Cited by 91 publications

(94 citation statements)

References 87 publications

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“…It can be argued that there may be a slight underestimation of GFR by ϳ10% using 51 Cr-EDTA in the present study. This is due to a small amount (12.15 Ϯ 0.59%) of 51 Cr-EDTA is plasma protein bound, and, consequently, this may affect their ultrafiltration (8,13). However, in the present experimental setup, arterial 51 Cr-EDTA levels were constant during the experiments, implying that also the protein-bound fraction of 51 Cr-EDTA must have been constant.…”

Section: Discussionmentioning

confidence: 52%

Renal extraction and acute effects of glucagon-like peptide-1 on central and renal hemodynamics in healthy men

Asmar

Simonsen

Asmar

et al. 2015

American Journal of Physiology-Endocrinology and Metabolism

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-The present experiments were performed to elucidate the acute effects of intravenous infusion of glucagon-like peptide (GLP)-1 on central and renal hemodynamics in healthy men. Seven healthy middle-aged men were examined on two different occasions in random order. During a 3-h infusion of either GLP-1 (1.5 pmol·kg Ϫ1 ·min Ϫ1 ) or saline, cardiac output was estimated noninvasively, and intraarterial blood pressure and heart rate were measured continuously. Renal plasma flow, glomerular filtration rate, and uptake/release of hormones and ions were measured by Fick's Principle after catheterization of a renal vein. Subjects remained supine during the experiments. During GLP-1 infusion, both systolic blood pressure and arterial pulse pressure increased by 5 Ϯ 1 mmHg (P ϭ 0.015 and P ϭ 0.002, respectively). Heart rate increased by 5 Ϯ 1 beats/min (P ϭ 0.005), and cardiac output increased by 18% (P ϭ 0.016). Renal plasma flow and glomerular filtration rate as well as the clearance of Na ϩ and Li ϩ were not affected by GLP-1. However, plasma renin activity decreased (P ϭ 0.037), whereas plasma levels of atrial natriuretic peptide were unaffected. Renal extraction of intact GLP-1 was 43% (P Ͻ 0.001), whereas 60% of the primary metabolite GLP-1 9-36amide was extracted (P ϭ 0.017). In humans, an acute intravenous administration of GLP-1 leads to increased cardiac output due to a simultaneous increase in stroke volume and heart rate, whereas no effect on renal hemodynamics could be demonstrated despite significant extraction of both the intact hormone and its primary metabolite.glucagon-like peptide-1; blood pressure; heart rate; cardiac output; renal plasma flow GLUCAGON-LIKE PEPTIDE (GLP)-1 is a 30-amino acid peptide hormone primarily synthesized by enteroendocrine L cells distributed in the small and large intestines and secreted in a nutrient-dependent manner. GLP-1 stimulates insulin secretion and inhibits glucagon secretion and gastric emptying, resulting in reduced postprandial glycemia (14). The GLP-1 receptor is a G protein-coupled receptor and a member of the glucagon receptor family (18). The GLP-1 receptor was originally identified in islet ␤-cells in the pancreas, but it is also widely expressed in extrapancreatic tissues in humans (17,25,33).GLP-1 receptor agonists have been approved for the treatment of hyperglycemia in subjects with diabetes, and, in addition, they may have significant cardiovascular effects (6, 28). However, results regarding the effects on arterial blood pressure are conflicting (2, 9, 11, 20 -22, 29, 31). The reasons for the apparent discrepancies are not clear, although differences between species, doses applied, and durations of treatment may contribute.Human studies have reported a natriuretic effect of native GLP-1, possibly due to reduced Na ϩ reabsorption in the proximal tubule (12,29). However, in a recent study (25) validating a new, monoclonal GLP-1 receptor antibody, GLP-1 receptors could not be identified in the proximal tubule, whereas they were expressed in renin-secreting ...

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Section: Discussionmentioning

confidence: 52%

Renal extraction and acute effects of glucagon-like peptide-1 on central and renal hemodynamics in healthy men

Asmar

Simonsen

Asmar

et al. 2015

American Journal of Physiology-Endocrinology and Metabolism

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“…Although nuclear medicine tests replaced inulin clearance worldwide in the 1970s, all nuclear medicine methods use tracers that have some plasma protein binding. This binding is low on average but shows significant variability (32). The results from this study were also formed as part of a post hoc analysis of a study that was designed for a different purpose, namely to show the superiority of CysC versus Cr as a surrogate endogenous GFR marker (33).…”

Section: Discussionmentioning

confidence: 99%

“…Many centers only use two sampling points instead of three and start sampling before the intravascular and extravascular spaces are equilibrated (32). Other strengths of the study include its large sample size (755 patients), broad age range of pediatric patients (2-17.9 years old), wide variety of renal pathologies, and wide range of GFR values within the cohort.…”

Section: Discussionmentioning

confidence: 99%

Estimation of GFR Using β-Trace Protein in Children

Witzel

Huang

Braam

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Sex may affect the performance of small molecular weight proteins as markers of GFR because of differences in fat mass between the two sexes. The hypothesis was that the diagnostic performance of b-trace protein, a novel marker of GFR, would be significantly better in boys than in girls.Design, setting, participants, & measurements GFR, height, weight, serum creatinine, and b-trace protein were measured in 755 children and adolescents (331 girls) undergoing 99 technetium diethylenetriamine penta-acetic acid renal scans from July of 1999 to July of 2006. Boys and girls were separated into formula generation cohorts (284 boys and 220 girls) and formula validation cohorts (140 boys and 111 girls). GFRestimating formulas on the basis of b-trace protein, creatinine, and height were derived using stepwise linear regression analysis of log-transformed data. The slope of the regression lines of the sex-specific eGFRs were compared. Bland-Altman analysis was used for testing agreement between 99 technetium diethylenetriamine penta-acetic acid GFR and calculated GFR both with this equation in boys and girls as well as previously established Benlamri, White, and Schwartz formulas. ResultsIn the stepwise regression analysis, b-trace protein (R 2 =0.73 for boys and R 2 =0.65 for girls) was more important than creatinine (which increased R 2 to 0.81 for boys and R 2 to 0.75 for girls) and height (which increased R 2 to 0.88 for boys and R 2 to 0.80 for girls) in the data generation groups. GFR can be calculated using the following formulas: Bland-Altman analysis showed better performance in boys than in girls. The new formulas performed significantly better than the previous Benlamri, White, and Schwartz formulas with respect to bias, precision, and accuracy.Conclusions Improved and sex-specific formulas for the estimation of GFR in children on the basis of b-trace protein, serum creatinine, and height are now available.

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“…Serum creatinine levels in children are much lower than in adults because they have less muscle mass, and the appropriate normal range for age must be used (Schwartz et al 1976). GFR calculation should be done with equations adapted to be suitable for young pediatric patients (Filler et al 2013, Langlois 2008Ring et al 2008, Schwartz andWork 2008;Schwartz et al 2009). …”

Section: Indicationsmentioning

confidence: 98%

Contrast Media Use in Pediatrics: Safety Issues

Riccabona

2014

Medical Radiology

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Methods of assessing renal function

Cited by 91 publications

References 87 publications

Renal extraction and acute effects of glucagon-like peptide-1 on central and renal hemodynamics in healthy men

Renal extraction and acute effects of glucagon-like peptide-1 on central and renal hemodynamics in healthy men

Estimation of GFR Using β-Trace Protein in Children

Contrast Media Use in Pediatrics: Safety Issues

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