Glomerular filtration rate via plasma iohexol disappearance:: Pilot study for chronic kidney disease in children
Glomerular filtration rate via plasma iohexol disappearance:: Pilot study for chronic kidney disease in children
复制标题
DOI：
10.1038/sj.ki.5000385
复制
发表时间：
2006-06-01
影响因子：
19.6
通讯作者：
Munoz, A.
中科院分区：
文献类型：
--
作者：
Schwartz, G. J.;Furth, S.;Munoz, A.
为了指导儿童慢性肾脏疾病的全国性队列研究的设计，我们确定了如何在儿童中使用碘海醇血浆消失曲线来测量肾小球滤过率（GFR）。静脉内给予碘海醇（5 ml），并在注射后10、20、30、60、120、240、300和360分钟（N = 29）获得血液样品，并通过高效液相色谱法进行分析。注射后还收集了4次尿液。100 mg/l、15 mg/l和一式两份未知血清的批内变异系数（CV）分别为1.3%、2.6%和3.4%。使用双指数模型，根据碘海醇剂量和9点血液消失曲线下的面积计算GFR（9）。在254个数据点中，只有2.8%的数据点偏离曲线> 3 CV。根据10、30、120和300分钟点计算的GFR（4）与GFR（9）相关性良好（r = 0.999），并且没有显示偏倚（平均值+/- s.d. GFR（9）和GFR（4）= 59.3 +/- 36.3和59.4 +/- 36.0 ml/min/1.73 m2）。GFR（9）和一室GFR的关系遵循Brochner-Mortensen先前报告的二次方程，允许从120和300 min点计算GFR。该GFR（2）与GFR（9）相关良好（r = 0.986）。Schwartz身高/肌酐公式估计的GFR与GFR（9）相关（r = 0.934），但高估了GFR 12.2 ml/min/1.73 m2。由于尿液采集的变异性（中位CV = 24%），尿碘海醇清除率与GFR（9）的相关性较差（r = 0.770）。GFR可以通过四点碘海醇血浆消失来准确测量（在大多数情况下，两点就足够了）;估计的GFR和尿清除率不太有用。
To guide the design of a nation-wide cohort study of chronic kidney disease in children, we determined how iohexol plasma disappearance curves could be used in children to measure glomerular filtration rate (GFR). lohexol (5 ml) was administered intravenously and blood samples were obtained at 10, 20, 30, 60, 120, 240, 300, and 360 min after injection (N = 29) and assayed by high performance liquid chromatography. Four urines were also collected following the injection. Intra-assay coefficient of variation (CV) in serum was 1.3% at 100 mg/l, 2.6% at 15 mg/l, and 3.4% for duplicate unknowns. GFR(9) was computed from iohexol dose and area under the nine-point blood disappearance curve, using double exponential modeling. Only 2.8% of 254 data points deviated by > 3 CV from the curves. GFR(4) calculated from 10, 30, 120, and 300 min points correlated well with GFR(9) (r = 0.999) and showed no bias (means +/- s.d. of GFR(9) and GFR(4) = 59.3 +/- 36.3 and 59.4 +/- 36.0 ml/min per 1.73 m(2)). Relationship of GFR(9) and one-compartment GFR followed quadratic equation as previously reported by Brochner-Mortensen, allowing GFR to be calculated from 120 and 300 min points. This GFR(2) correlated well with GFR(9) (r = 0.986). Estimated GFR from Schwartz height/creatinine formula correlated with GFR(9)(r = 0.934) but overestimated GFR by 12.2 ml/min per 1.73 m(2). Urine iohexol clearance was poorly correlated (r = 0.770) with GFR(9) owing to variability in urine collections (median CV = 24%). GFR can be measured accurately using four-point iohexol plasma disappearance (in most cases, two points suffice); estimated GFR and urinary clearances are less useful.