Selection of Routine Method for Determination of Glomerular Filtration Rate in Adult Patients

Abstract

The precision and reporducibility of three different clearance methods as used in clinical routine assessment of glomerular filtration rate (GFR) were investigated in 51 patients: total [51Cr]EDTA plasma clearance (E); 24-hr endogenous creatinine clearance (C); and creatinine clearance estimated from the plasma creatinine concentration, weight, and sex- and age-dependent mean creatinine excretion rate (c). The precision and reporducibility (coefficient of variation) for single determinations were, in patients with E greater than 30 ml/min, 5.5 and 4.1% (E); 26.9% (C); and 23.2 and 11.0% (c). The corresponding figures for E less than 30 ml/min were 11.6 and 11.5% (E); 21.9% (C); and 21.4 and 6.5% (c). The precision of C could not be ameliorated by excluding single deviating determinations, but only by excluding patients for whom the precision of 15.5% for mean of three determinations of C (total material) could be reduced to 10% by excluding 25% of the patients. The present data indicate that E in most cases is the method of choice for assessment of GFR in clinical routine work. For changes in renal function, especially at low functional levels, c may be of value.

Plasma N-terminal pro-brain natriuretic peptide as an independent predictor of mortality in diabetic nephropathy

“…The prevalence of major cardiovascular events differed between patients with and without diabetic nephropathy (11% [95% CI [8][9][10][11][12][13][14] and 2% [0-4], respectively, p<0.0001). In patients with nephropathy, plasma NTproBNP at baseline was significantly elevated in patients with a history of nonfatal myocardial infarction and/or stroke (671 [34-12,418] ng l −1 , p<0.0001) as compared with patients without a history of major cardiovascular disease (97 640] ng l −1 ).…”

“…Serum creatinine concentration was assessed by a kinetic Jaffé method. Glomerular filtration rate was measured in patients with diabetic nephropathy after a single injection of 3.7 MBq 51 Cr-EDTA by determination of radioactivity in venous blood samples taken 180, 200, 220 and 240 min after the injection [14]. In normoalbuminuric patients glomerular filtration rate was estimated by the Modification of Diet in Renal Disease equation [15].…”

Plasma osteoprotegerin levels predict cardiovascular and all-cause mortality and deterioration of kidney function in type 1 diabetic patients with nephropathy

“…Serum creatinine concentration was determined by a modification of Jaffe's method. GFR was measured annually in patients with diabetic nephropathy after a single injection of 3.7 MBq 51 Cr-labelled EDTA by determination of radioactivity in venous blood samples taken 180, 200, 220 and 240 min after injection [25]. Linear regression analysis of serial GFR determinations in each individual was used to estimate the rate of decline in kidney function with time (ΔGFR).…”

Pregnancy and progression of diabetic nephropathy

“…An annual measurement of glomerular filtration rate (GFR) was introduced in 1984 [16]. Consequently, only a subset (n = 59) of the 93 patients included in the study had this examination.…”