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Laurence Dubourg - One of the best experts on this subject based on the ideXlab platform.
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comparison of iohexol plasma Clearance formulas vs Inulin urinary Clearance for measuring glomerular filtration rate
Clinical Chemistry and Laboratory Medicine, 2021Co-Authors: Pierre Cochat, Laurence Dubourg, Sandrine Lemoine, Brune Joannard, Laurence Chardon, Vandrea De Souza, Jean IwazAbstract:Objectives The one-compartment iohexol plasma Clearance has been proposed as a reliable alternative to renal Inulin Clearance. However, this method's performance depends on the formula used to calculate glomerular filtration rate (GFR). This study reports on performance comparisons between various mathematical formulas proposed for iohexol plasma Clearance vs. Inulin urinary Clearance. Methods GFR was simultaneously determined by Inulin and iohexol Clearance in 144 participants (age: 10-84 years; glomerular filtration rate: 15-169 mL/min/1.73 m2). A retrospective cross-sectional study evaluated the performance of four formulas proposed to calculate plasma iohexol Clearance (Brochner-Mortensen, Fleming et al., Jodal-Brochner-Mortensen, and Ng-Schwartz-Munoz). The performance of each formula was assessed using bias, precision (standard deviation of the bias), accuracy (percentage iohexol within 5, 10, and 15%), root mean square error, and concordance correlation coefficient vs. renal Inulin Clearance as reference. Results Regarding accuracy, there was no difference in root mean square error (RMSE), P5, P10, or P15 between the four formulas. The four concordance correlation coefficients (CCC) between the value from each formula and in-GFR were high and not significantly different. At in-GFR ≥90 mL/min/1.73 m2, Ng-Schwartz-Munoz formula performed slightly better than other formulas regarding median bias (-0.5; 95% CI [-3.0 to 2.0] and accuracy P15 (95.0; 95% CI [88.0-100.0]). Conclusions The studied formulas were found equivalent in terms of precision and accuracy, but the Ng-Schwartz-Munoz formula improved the accuracy at higher levels of in-GFR.
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diagnostic performance of creatinine based equations for estimating glomerular filtration rate in adults 65 years and older
JAMA Internal Medicine, 2019Co-Authors: Luciano Selistre, Sandrine Lemoine, Vandrea De Souza, Jean Iwaz, Dener Lizot Rech, Laurence DubourgAbstract:Importance Estimating glomerular filtration rate (GFR) is useful in many clinical conditions. However, very few studies have evaluated the performance of GFR-estimating equations in older adults at various degrees of kidney impairment. Objective To determine the performance of plasma-creatinine-based equations Chronic Kidney Disease–Epidemiology Collaboration (CKD-EPI), Lund-Malmo Revised, (LMR), full age spectrum (FAS), and Berlin Initiative Study (BIS) 1 in older adults across a broad spectrum of GFRs. Design, Setting, and Participants Single-center cross-sectional study performed in France including 2247 participants aged 65 to 90 years who underwent Inulin GFR measurements from July 1, 2003, to July 30, 2017, for suspected or established renal dysfunction, for renal risk, before kidney donation, or after kidney transplant. Main Outcomes and Measures The main outcome measure was GRF measured by Inulin Clearance. Equation performance criteria considered bias (difference between estimated and measured GFR), precision (interquartile range of the median difference), and accuracy P30(percentage of estimated GFRs lying between [measured GFR – 30% of measured GFR] and [measured GFR + 30% of measured GFR]). Results The mean (SD) age of the 2247 participants was 71.5 (5) years and 1192 (53.0%) were male. The difference in median (95% CI) bias was significant between CKD-EPI vs LMR (−4.0 [–4.0 to –3.5 mL/min/1.73 m2;P Conclusions and Relevance In a referral group of patients 65 years and older who had GFR estimated using CDK-EPI, LMR, BIS 1, and FAS equations, a comparison with renal Inulin Clearance found that none of the equations had a superior diagnostic performance. Each had limitations regarding accuracy.
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comparison of cystatin c and creatinine based glomerular filtration rate formulas with Inulin Clearance in pediatric renal transplantation
Transplantation proceedings, 2012Co-Authors: Luciano Selistre, Aoumeur Hadjaissa, O Roquet, David Saitovitch, V C De Souza, Ivan Carlos Ferreira Antonello, Bruno Ranchin, P Cochat, Laurence DubourgAbstract:Abstract Background It has been suggested that plasma cystatin C (Cyst-C) concentrations provide better indicators of changes in glomerular filtration rate (GFR) than plasma creatinine concentration (PCr). Methods We compared the performance of five equations—2009 Schwartz, Local Schwartz, Larsson, Le Bricon, and Schwartz Combined—in 60 renal transplant children by calculating the mean bias, Pearson correlation coefficient ( R ) and determination ( R 2 ), 10% (P10) and 30% (P30) accuracies, and Bland-Altman plots. GFR was measured by Inulin Clearance. Results For the whole population, R 2 was slightly lower for formulas based on Cyst-C or PCr, but the mean bias was lower, and P10 and P30 were greater, than using combined Schwartz equation. However, the mean estimated GFR by Schwartz 2009, Local Schwartz, and Schwartz combined equations was not statistically different from the mean Inulin Clearance measurement. Conclusions In our pediatric transplant population, the combined Schwartz formula exhibited better performance to estimate GFR than formulae based on Cyst-C or combined PCr.
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what is the best alternative to Inulin Clearance to estimate gfr in patients with decompensated alcoholic cirrhosis
Nephrology Dialysis Transplantation, 2010Co-Authors: Nicolas Rognant, Justine Bacchetta, Laurence Dubourg, Si Nafaa Si Ahmed, Sylvie Radenne, Jerome Dumortier, Aoumeur HadjaissaAbstract:Background. Accurate evaluation of the glomerular filtration rate (GFR) in patients awaiting liver transplantation is important because they have a greater risk of impaired renal function. A major percentage of these patients have alcoholic cirrhosis, and the accuracy of bedside used GFR estimates have not been specifically evaluated in this group. The aim of this study was to evaluate the validity of the simplified Modification of Diet in Renal Diseases (MDRD) and Cockcroft and Gault (CG) formulas in patients with decompensated alcoholic cirrhosis in comparison to Inulin Clearance as the reference method. Methods. GFR estimated by the simplified MDRD and CG formulas were retrospectively compared to the true GFR measured by Inulin Clearance in a single-centre cohort of 148 patients with decompensated alcoholic cirrhosis. Results. Mean ± standard deviation of age, body mass index, Inulin Clearance and MDRD and CG estimates were 54.4 ± 6.9 years, 26.5 ± 4.7 kg/m 2 , 76.9 ± 28.0mL/min per 1.73 m 2 , 99.4 ± 34.0 mL/min per 1.73 m 2 and 98.7 ± 32.0 mL/min per 1.73 m 2 , respectively; 70% of the patients had a GFR, measured by Inulin Clearance, below 90 mL/min per 1.73 m 2 . The difference between estimated GFR and true GFR were 23 ± 23 mL/min per 1.73 m 2 for MDRD and 22 ±2 0 mL/min per 1.73 m 2 for Cockcroft and Gault. Conclusions. The simplified MDRD and CG formulas largely overestimated GFR in patients with decompensated alcoholic cirrhosis. Results of such bedside formulas should be interpreted with caution in these patients.
Jonas Björk - One of the best experts on this subject based on the ideXlab platform.
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new standardized cystatin c and creatinine gfr equations in children validated with Inulin Clearance
Pediatric Nephrology, 2015Co-Authors: Ulla B. Berg, Ulf Nyman, Rune Back, Magnus Hansson, Kajsa Asling Monemi, Maria Herthelius, Jonas BjörkAbstract:Background This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal Clearance of Inulin (C-Inulin). Methods A total of 220 children with different renal disorders were referred for C-Inulin (median 84 ml/min/1.73 m 2 ). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates ±30 % of C-Inulin; P30) were evaluated for two cystatinC equations, CAPACYSC and BergCYSC, for creatinine equations, SchwartzCREA and GaoCREA, the arithmetic mean of CAPACYSC and SchwartzCREA (MEANCAPA+Schwartz), BergCYSC and SchwartzCREA (MEANBERG+SCHWARTZ) and the composite equation ChehadeCYSC+CREA. Results Overall results of CAPACYSC ,B erg CYSC, SchwartzCREA ,G ao CREA ,M EAN CAPA+Schwartz, MEANBERG+SCHWARTZ andChehadeCYSC+CREAwere:median bias –7.6/–4.9/–3.7/–2.3/–4.6/–4.0/–10.1 %, IQR 20.0/ 19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m 2 and P30 86/ 86/80/83/89/91/83 %. The cystatin C equations, MEANCAPA+Schwartz and MEANBERG+SCHWARTZ had a more stable performance across subgroups compared with SchwartzCREA ,G aoCREA and ChehadeCYSC+CREA. Conclusions CystatinC wasthepreferredfiltrationmarkerfor GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.
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new standardized cystatin c and creatinine gfr equations in children validated with Inulin Clearance
Pediatric Nephrology, 2015Co-Authors: Ulla B. Berg, Ulf Nyman, Rune Back, Magnus Hansson, Kajsa Asling Monemi, Maria Herthelius, Jonas BjörkAbstract:Background This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal Clearance of Inulin (C-Inulin).
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measuring gfr a systematic review
American Journal of Kidney Diseases, 2014Co-Authors: Inga Soveri, Ulla B. Berg, Jonas Björk, Carl-gustaf Elinder, Anders Grubb, Ingegerd Mejàre, Gunnar Sterner, Sten-erik BäckAbstract:BACKGROUND: No comprehensive systematic review of the accuracy of glomerular filtration rate (GFR) measurement methods using renal Inulin Clearance as reference has been published. STUDY DESIGN: Systematic review with meta-analysis of cross-sectional diagnostic studies. SETTING & POPULATION: Published original studies and systematic reviews in any population. SELECTION CRITERIA FOR STUDIES: Index and reference measurements conducted within 48 hours; at least 15 participants studied; GFR markers measured in plasma or urine; plasma Clearance calculation algorithm verified in another study; tubular secretion of creatinine had not been blocked by medicines. INDEX TESTS: Endogenous creatinine Clearance; renal or plasma Clearance of chromium 51-labeled ethylenediaminetetraacetic acid (51Cr-EDTA), diethylenetriaminepentaacetic acid (DTPA), iohexol, and iothalamate; and plasma Clearance of Inulin. REFERENCE TEST: Renal Inulin Clearance measured under continuous Inulin infusion and urine collection. RESULTS: Mean bias 90%. LIMITATIONS: The included studies were few and most were old and small, which may limit generalizability. Requirements for sufficient accuracy may depend on clinical setting. CONCLUSIONS: At least moderately strong evidence suggests that renal Clearance of 51Cr-EDTA or iothalamate and plasma Clearance of 51Cr-EDTA or iohexol are sufficiently accurate methods to measure GFR.
Klaus Jung - One of the best experts on this subject based on the ideXlab platform.
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β trace protein is not better than cystatin c as an indicator of reduced glomerular filtration rate
Clinical Chemistry, 2001Co-Authors: Friedrich Priem, Harald Althaus, Klaus Jung, Pranav SinhaAbstract:Recent studies suggest that serum cystatin C [reviewed in Refs. (1)(2)] and β-trace protein (3)(4) identify reductions in glomerular filtration rate (GFR) better than creatinine does. Woitas et al. (5) compared for the first time the diagnostic performance of cystatin C, β-trace protein, β2-microglobulin, and creatinine in relation to Inulin Clearance. They noted that we reported a higher diagnostic accuracy of β-trace protein in a study with 115 diabetic patients (4). As explanation, Woitas et al. (5) offered different patient characteristics. In …
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β trace protein in serum a new marker of glomerular filtration rate in the creatinine blind range
Clinical Chemistry, 1999Co-Authors: Friedrich Priem, Maria Birnbaum, Harald S. Conradt, Harald Althaus, Pranav Sinha, Klaus JungAbstract:Recent studies have shown that low-molecular weight proteins in serum seem to be better markers for detecting reduced glomerular filtration rate (GFR) than the conventional measurement of serum creatinine (1)(2). Several proteins, such as ribonuclease, α1-microglobulin, β2-microglobulin (B2M), and cystatin C have been compared with serum creatinine (2)(3). Whereas serum creatinine is increased only after a reduction of ∼50% in GFR, the above proteins, especially cystatin C, are already increased within that so-called creatinine-blind range (1)(4)(5)(6). Recently, another low-molecular weight protein, the β-trace protein (BTP), isolated primarily from cerebrospinal fluid (7), was shown to be increased in patients with renal diseases (8)(9). However, there is no information on the relationship of BTP and a standard measure of GFR such as Inulin Clearance. Therefore, to investigate the potential clinical usefulness of BTP for early detection of reduced GFR, we have performed corresponding measurements of BTP and Inulin Clearance. The study included 115 diabetic patients (44 women; mean age, 53.4 years; 71 men, mean age, 52.9 years); 57 had type I diabetes and 58 had type II. GFR was determined by …
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Practical approach for determining glomerular filtration rate by single-injection Inulin Clearance
Clinical Chemistry, 1992Co-Authors: Klaus Jung, Wolfgang Henke, Bernd-detlef Schulze, Sydow K, Klaus Precht, Silke KlotzekAbstract:We compared the glomerular filtration rate as measured by a single-injection Inulin Clearance with that measured by a standard isotope method with 99mTc-labeled diethylenetriaminopentaacetic acid in 21 subjects with glomerular filtration rates greater than 35 mL/min. After a bolus injection of 5 g of Inulin, blood samples were taken 20, 45, 90, 120, 145, 180, and 240 min afterwards. Inulin was measured by optimized chemical or enzymatic methods of high analytical sensitivity to determine Inulin at low concentrations. We used the one-compartment model and Inulin concentrations measured at two sampling times to calculate the glomerular filtration rate from the data of the disappearance curve of Inulin. Inulin concentrations at 20 and 240 min after injection of the Inulin bolus were suited to estimate glomerular filtration rate by this procedure, resulting in values (y) comparable with those obtained by isotope technique (x). The relationship to the isotope technique was characterized by the equation y = +4.80 mL/min + 0.92x (r = 0.97). The single-injection Inulin Clearance determination can detect a decrease of glomerular filtration rate at the beginning of kidney damage, given that our study included subjects with glomerular filtration rates greater than 35 mL/min. We conclude that the glomerular filtration rate can be determined by analyzing only two blood samples after a bolus injection of Inulin.
Ulla B. Berg - One of the best experts on this subject based on the ideXlab platform.
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new standardized cystatin c and creatinine gfr equations in children validated with Inulin Clearance
Pediatric Nephrology, 2015Co-Authors: Ulla B. Berg, Ulf Nyman, Rune Back, Magnus Hansson, Kajsa Asling Monemi, Maria Herthelius, Jonas BjörkAbstract:Background This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal Clearance of Inulin (C-Inulin). Methods A total of 220 children with different renal disorders were referred for C-Inulin (median 84 ml/min/1.73 m 2 ). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates ±30 % of C-Inulin; P30) were evaluated for two cystatinC equations, CAPACYSC and BergCYSC, for creatinine equations, SchwartzCREA and GaoCREA, the arithmetic mean of CAPACYSC and SchwartzCREA (MEANCAPA+Schwartz), BergCYSC and SchwartzCREA (MEANBERG+SCHWARTZ) and the composite equation ChehadeCYSC+CREA. Results Overall results of CAPACYSC ,B erg CYSC, SchwartzCREA ,G ao CREA ,M EAN CAPA+Schwartz, MEANBERG+SCHWARTZ andChehadeCYSC+CREAwere:median bias –7.6/–4.9/–3.7/–2.3/–4.6/–4.0/–10.1 %, IQR 20.0/ 19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m 2 and P30 86/ 86/80/83/89/91/83 %. The cystatin C equations, MEANCAPA+Schwartz and MEANBERG+SCHWARTZ had a more stable performance across subgroups compared with SchwartzCREA ,G aoCREA and ChehadeCYSC+CREA. Conclusions CystatinC wasthepreferredfiltrationmarkerfor GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.
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new standardized cystatin c and creatinine gfr equations in children validated with Inulin Clearance
Pediatric Nephrology, 2015Co-Authors: Ulla B. Berg, Ulf Nyman, Rune Back, Magnus Hansson, Kajsa Asling Monemi, Maria Herthelius, Jonas BjörkAbstract:Background This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal Clearance of Inulin (C-Inulin).
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measuring gfr a systematic review
American Journal of Kidney Diseases, 2014Co-Authors: Inga Soveri, Ulla B. Berg, Jonas Björk, Carl-gustaf Elinder, Anders Grubb, Ingegerd Mejàre, Gunnar Sterner, Sten-erik BäckAbstract:BACKGROUND: No comprehensive systematic review of the accuracy of glomerular filtration rate (GFR) measurement methods using renal Inulin Clearance as reference has been published. STUDY DESIGN: Systematic review with meta-analysis of cross-sectional diagnostic studies. SETTING & POPULATION: Published original studies and systematic reviews in any population. SELECTION CRITERIA FOR STUDIES: Index and reference measurements conducted within 48 hours; at least 15 participants studied; GFR markers measured in plasma or urine; plasma Clearance calculation algorithm verified in another study; tubular secretion of creatinine had not been blocked by medicines. INDEX TESTS: Endogenous creatinine Clearance; renal or plasma Clearance of chromium 51-labeled ethylenediaminetetraacetic acid (51Cr-EDTA), diethylenetriaminepentaacetic acid (DTPA), iohexol, and iothalamate; and plasma Clearance of Inulin. REFERENCE TEST: Renal Inulin Clearance measured under continuous Inulin infusion and urine collection. RESULTS: Mean bias 90%. LIMITATIONS: The included studies were few and most were old and small, which may limit generalizability. Requirements for sufficient accuracy may depend on clinical setting. CONCLUSIONS: At least moderately strong evidence suggests that renal Clearance of 51Cr-EDTA or iothalamate and plasma Clearance of 51Cr-EDTA or iohexol are sufficiently accurate methods to measure GFR.
Masaru Horio - One of the best experts on this subject based on the ideXlab platform.
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assessment of renal function in living kidney donors before and after nephrectomy a japanese prospective observational cohort study
International Journal of Urology, 2019Co-Authors: Yoichi Kakuta, Masaru Horio, Shiro Takahara, Ryoichi Imamura, Masayoshi Okumi, Yoshitaka Isaka, Naotsugu Ichimaru, Norio Nonomura, Kazunari TanabeAbstract:OBJECTIVE To investigate the utility of estimated glomerular filtration rate for assessing kidney function in living kidney donors before and after nephrectomy. METHODS A total of 101 donors underwent Inulin Clearance measurements before and 1 year after nephrectomy. The mean of three Inulin Clearance values was used as the measured glomerular filtration rate. Estimated glomerular filtration rate based on serum creatinine and cystatin C levels was calculated using the Japanese estimated glomerular filtration rate equation, Chronic Kidney Disease Epidemiology Collaboration formula and new full age spectrum equation. Age-adjusted chronic kidney disease was defined as glomerular filtration rate 65 years. RESULTS The postoperative measured glomerular filtration rate 70 years), postoperative measured glomerular filtration rate <60 mL/min/1.73m2 and age-adjusted chronic kidney disease rates were 75.0% and 33.3%, respectively. Donor age and measured glomerular filtration rate were significant predictors of postoperative measured glomerular filtration rate. The Japanese estimated glomerular filtration rate equation based on creatinine and cystatin C showed the strongest correlation with measured glomerular filtration rate. However, the Japanese estimated glomerular filtration rate equation based on creatinine overestimated the prevalence of measured glomerular filtration rate <60 mL/min/1.73m2 , whereas the Japanese estimated glomerular filtration rate based on cystatin C underestimated it. CONCLUSIONS Aged donors might have an increased risk of lower glomerular filtration rate after donor nephrectomy; post-surgery, long-term monitoring of renal function is recommended. Measurement of glomerular filtration rate should be carried out for donors, especially pre-surgery. A more precise glomerular filtration rate equation is required in the future.
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Additional file 1: Table S1. of Existing creatinine-based equations overestimate glomerular filtration rate in Indians
2018Co-Authors: Vivek Kumar, Masaru Horio, Yoshinari Yasuda, Seiichi Matsuo, Ashok Yadav, Vinod Kumar, Nancy Sahni, Krishan Gupta, Harbir Kohli, Vivekanand JhaAbstract:Estimating GFR equations. Table S2. Characteristics and measurements in study population (stratified by mGFR groups). Table S3. Performance of GFR estimating equations as compared to measured GFR by urinary Inulin Clearance (stratified by mGFR groups). Table S4. GFR measurements in study population (stratified by age). Table S5. Performance of GFR estimating equations as compared to measured GFR by urinary Inulin Clearance (stratified by age). Table S6. Performance of GFR estimating equations (eGFR calculated using serum creatinine values by modified Jaffe method) as compared to measured GFR by urinary Inulin Clearance. (DOCX 76Â kb
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comparison of a simple and a standard method for Inulin renal Clearance
Clinical and Experimental Nephrology, 2010Co-Authors: Masaru Horio, Enyu Imai, Yoshinari Yasuda, Shiro Takahara, Tsuyoshi Watanabe, Seiichi MatsuoAbstract:Background The standard method of renal Inulin Clearance consists of three sets of 30-min Clearances. We previously proposed a simple method with a single urine collection for 1 h and two blood samples. In this study, we compared the two methods.
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simple sampling strategy for measuring Inulin renal Clearance
Clinical and Experimental Nephrology, 2009Co-Authors: Masaru Horio, Enyu Imai, Yoshinari Yasuda, Akira Hishida, Seiichi MatsuoAbstract:Background In the standard method of Inulin Clearance (Cin), three sets of serum and urine samples are collected during a 2-hour Clearance period. For a practical use of this method, sampling should be the minimal number allowable while still providing enough accuracy. The aim of this study was to evaluate the validity of Inulin renal Clearance with assumed single urine collection with a period such as 30, 60 or 90 minutes.
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simple sampling strategy for measuring Inulin renal Clearance
Clinical and Experimental Nephrology, 2009Co-Authors: Masaru Horio, Enyu Imai, Yoshinari Yasuda, Akira Hishida, Seiichi MatsuoAbstract:In the standard method of Inulin Clearance (Cin), three sets of serum and urine samples are collected during a 2-hour Clearance period. For a practical use of this method, sampling should be the minimal number allowable while still providing enough accuracy. The aim of this study was to evaluate the validity of Inulin renal Clearance with assumed single urine collection with a period such as 30, 60 or 90 minutes. Inulin Clearance data collected by the standard method from 737 individuals were used. Changes of serum Inulin concentrations between 45 and 105 minutes after the start of the infusion were analyzed. We used first urine collection to calculate the Inulin Clearance with single urine collection (Cin-30 min). We assumed single urine collection for 60 or 90 minutes by combining the urine data of the consecutive 30-minute periods. Inulin Clearances (Cin-60 min, Cin-90 min) were calculated from the assumed single urine collections, respectively. Serum Inulin concentration did not reach equilibrium during the Clearance period. It increased in subjects with low glomerular filtration rate (GFR) and decreased in subjects with normal GFR. The amount of the change was small and −0.5 ± 12.6% in subjects with GFR over 30 ml/min per 1.73 m2. Cin-30 min, Cin-60 min and Cin-90 min showed high correlation coefficients against Cin-ST (0.962, 0.988 and 0.998, respectively). Systemic biases in these Clearances were negligible (under 1 ml/min per 1.73 m2). Root mean square error (RMSE) were 10.4, 5.3 and 2.3 ml/min per 1.73 m2 for Cin-30 min, Cin-60 min and Cin-90 min, respectively. These data indicated that accuracy of Inulin Clearance depends on the duration of the urine collection period. Inulin Clearance with a single urine collection is a convenient method. We showed that single urine collection for 30 minutes or a longer period has reasonable accuracy in calculation of Inulin Clearance. We propose a method of Inulin Clearance with single urine collection for 60 minutes.
