Reassessment of a classical single injection<sup>51</sup>Cr‐EDTA clearance method for determination of renal function in children and adults. Part II: Empirically determined relationships between total and one‐pool clearance

Brøchner‐Mortensen, Jens; Jødal, Lars

doi:10.1080/00365510802653680

Cited by 28 publications

(25 citation statements)

References 22 publications

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“…A post hoc analysis after Brochner-Mortensen correction (26) of the 51 Cr-GFR demonstrated stronger agreement and correlation with 68 Ga-GFR, with a Bland-Altman bias of 21.3 (SD, 11; 95% CI, 223 to 20) and a PCC of 0.95. Our current study showed that both 68 Ga-GFR and 51 Cr-GFR agreed well with GFR estimated by MDRD or CKD-EPI.…”

Section: Discussionmentioning

confidence: 92%

⁶⁸Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional ⁵¹Cr-EDTA

et al. 2015

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Glomerular filtration rate (GFR) can accurately be determined using 51 Cr-ethylenediaminetetraacetic acid (EDTA) plasma clearance counting but is time-consuming and requires technical skills and equipment not always available in imaging departments. 68 Ga-EDTA can be readily available using an onsite generator, and PET/CT enables both imaging of renal function and accurate camera-based quantitation of clearance of activity from blood and its appearance in the urine. This study aimed to assess agreement between 68 Ga-EDTA GFR ( 68 Ga-GFR) and 51 Cr-EDTA GFR ( 51 Cr-GFR), using serial plasma sampling and PET imaging. Methods: 68 Ga-EDTA and 51 Cr-EDTA were injected concurrently in 31 patients. Dynamic PET/CT encompassing the kidneys was acquired for 10 min followed by 3 sequential 3-min multibed step acquisitions from kidneys to bladder. PET quantification was performed using renal activity at 1-2 min (PET initial ), renal excretion at 2-10 min (PET early ), and, subsequently, urinary excretion into the collecting system and bladder (PET late ). Plasma sampling at 2, 3, and 4 h was performed, with 68 Ga followed by 51 Cr counting after positron decay. The level of agreement for GFR determination was calculated using a Bland-Altman plot and Pearson correlation coefficient (PCC). Results: 51 Cr-GFR ranged from 10 to 220 mL/min (mean, 85 mL/min). There was good agreement between 68 Ga-GFR and 51 Cr-GFR using serial plasma sampling, with a BlandAltman bias of −14 ± 20 mL/min and a PCC of 0.94 (95% confidence interval, 0.88-0.97). Of the 3 methods used for camera-based quantification, the strongest correlation was for plasma sampling-derived GFR with PET late (PCC of 0.90; 95% confidence interval,. Conclusion: 68 Ga-GFR agreed well with 51 Cr-GFR for estimation of GFR using serial plasma counting. PET dynamic imaging provides a method to estimate GFR without plasma sampling, with the additional advantage of enabling renal imaging in a single study. Additional validation in a larger cohort is warranted to further assess utility.

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Section: Discussionmentioning

confidence: 92%

⁶⁸Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional ⁵¹Cr-EDTA

et al. 2015

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“…They further mention that on using second-order polynomials the reference clearance is increasingly underestimated at high clearance values (on average 10% at 175 ml/min/1.73 m 2 ) [9]. However, it should be noted that the maximum value of 200 ml/min corresponds with a slow GFR of 406.7 ml/min [ = 0.990778/(2 × 0.001218)], a value that is more than double the range of the original BM correction formula, and a value so high that it has never been reported before.…”

Section: Discussionmentioning

confidence: 97%

Measuring glomerular filtration rate using 51Cr-EDTA

Pottel

Hoste²,

Waele³

et al. 2014

Nuclear Medicine Communications

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“…GFR equations to quantify a universal relationship between the 1-compartment (slow) and the 2-compartment (slow + fast) plasma disappearance models have been published, based on diverse, but small, study samples (combining adults and children) representing different clinical populations (i.e., varying levels of renal function) [7;8;9]. Thus, the purpose of the current study was to develop a formula to determine the 2-compartment GFR for studies where samples in the fast compartment are not collected.…”

Section: Introductionmentioning

confidence: 99%

Universal GFR determination based on two time points during plasma iohexol disappearance

Schwartz

Jacobson

et al. 2011

Kidney International

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An optimal measurement of glomerular filtration rate (GFR) should minimize the number of blood draws, and reduce procedural invasiveness and the burden to study personnel and cost, without sacrificing accuracy. Equations have been proposed to calculate GFR from the slow compartment separately for adults and children. To develop a universal equation, we used 1347 GFR measurements from two diverse groups consisting of 527 men in the Multi center AIDS Cohort Study and 514 children in the Chronic Kidney Disease in Children cohort. Both studies used nearly identical two-compartment (fast and slow) protocols to measure GFR. To estimate the fast component from markers of body size and of the slow component, we used standard linear regression methods with the log-transformed fast area as the dependent variable. The fast area could be accurately estimated from body surface area by a simple parameter (6.4/body surface area) with no residual dependence on the slow area or other markers of body size. Our equation measures only the slow iohexol plasma disappearance curve with as few as two time points and was normalized to 1.73m2 body surface area. It is of the form: GFR=slowGFR/[1+0.12 (slowGFR/100)]. In a random sample utilizing a third of the patients for validation, there was excellent agreement between the calculated and measured GFR with low root mean square errors being 4.6 and 1.5ml/min per 1.73m2 for adults and children, respectively. Thus, our proposed simple equation, developed in a combined patient group with a broad range of GFRs, may be applied universally and is independent of the injected amount of iohexol.

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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

Abstract: We suggest that the tested correction equations are replaced by the given common correction equation based on the "true" relationship between Cl(1) and Cl thoroughly described in part I of this study.

Cited by 28 publications

References 22 publications

⁶⁸Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional ⁵¹Cr-EDTA

⁶⁸Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional ⁵¹Cr-EDTA

Measuring glomerular filtration rate using 51Cr-EDTA

Universal GFR determination based on two time points during plasma iohexol disappearance

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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

Abstract: We suggest that the tested correction equations are replaced by the given common correction equation based on the "true" relationship between Cl(1) and Cl thoroughly described in part I of this study.

Cited by 28 publications

References 22 publications

68Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional 51Cr-EDTA

68Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional 51Cr-EDTA

Measuring glomerular filtration rate using 51Cr-EDTA

Universal GFR determination based on two time points during plasma iohexol disappearance

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Resources

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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

⁶⁸Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional ⁵¹Cr-EDTA

⁶⁸Ga-EDTA PET/CT Imaging and Plasma Clearance for Glomerular Filtration Rate Quantification: Comparison to Conventional ⁵¹Cr-EDTA