Accuracy of iohexol plasma clearance for GFR-determination: a comparison between single and dual sampling

作者：Zhang, Yong; Sui, Zhun; Yu, Ze; Li, Tai Feng; Feng, Wan Yu; Zuo, Li^*

来源：BMC Nephrology, 2018, 19(1): 174.

DOI：10.1186/s12882-018-0965-7

• Glomerular filtration rate
• Plasma clearance
• Iohexol
• Single sample
• Slope-intercept

Background: Current guidelines regarding plasma-sampling techniques for glomerular filtration rate (GFR) determination are inconsistent. Single-sample methods are commonly believed not to be precise enough to meet clinical demands. The present study compared the agreement between single-and dual-plasma sampling methods with a three-point plasma clearance of iohexol. @@@ Methods: A total of 46 healthy volunteers and 124 chronic kidney disease (CKD) patients with varying degrees of renal dysfunction received 5 ml iohexol (300 mgI/ml) i.v. and plasma samples were drawn at 2-, 3- and 4-h post-injection. Plasma-iodine concentrations were detected by high-performance liquid chromatography (HPLC). @@@ Results: Bias was similar among single-plasma sampling methods (SPSM) and dual-plasma sampling methods (DPSM). The best correlation was obtained from the 2- and 4-h DPSM (concordance correlation coefficient [CCC]: 0.9988) with none of the estimates differed by more than 30% from the reference GFR and only one (0.06%) estimate differed by more than 10% (P30, 100%; P10, 99.4%). SPSM using samples around 3- or 4-h demonstrated acceptable accuracy at a GFR level of >= 60 ml/min/1.73 m(2) (P-30 = 100% and P-10 > 75% for both measurements). @@@ Conclusion: 4-h SPSM is advantageous in clinical practice in subjects with GFR = 60 ml/min/1.73 m(2). For patients with an expected GFR < 60 ml/min/1.7 3m(2), a prolonged sampling time is more reliable.

• 出版日期2018-7-11
• 单位北京大学