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The reliability of glomerular filtration rate measured from plasma clearance: a multi-centre study of 1,878 healthy potential renal transplant donors

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Abstract

Purpose

The objective of the study was to undertake a clinical audit of departmental performance in the measurement of glomerular filtration rate (GFR) using the coefficient of variation (CV) of extracellular fluid volume (ECFV) as the benchmark. ECFV is held within narrow limits in healthy subjects, narrower than GFR, and should therefore have a low CV.

Methods

Fifteen departments participated in this retrospective study of healthy renal transplant donors. Data were analysed separately for men (n ranged from 28 to 115 per centre; total = 819) and women (n = 28–146; 1,059). All centres used the slope-intercept method with blood sample numbers ranging from two to five. Subjects did not fast prior to GFR measurement. GFR was scaled to body surface area (BSA) and corrected for the single compartment assumption. GFR scaled to ECFV was calculated as the terminal slope rate constant and corrected for the single compartment assumption. ECFV/BSA was calculated as the ratio of GFR/BSA to GFR/ECFV.

Results

The departmental CVs of ECFV/BSA and GFR/BSA ranged from 8.3 to 25.8% and 12.8 to 21.9%, respectively, in men, and from 9.6 to 21.1% and 14.8 to 23.7%, respectively, in women. Both CVs correlated strongly between men and women from the same centre, suggesting department-specific systematic errors. GFR/BSA was higher in men in 14 of 15 centres, whereas GFR/ECFV was higher in women in 14 of 15 centres. Both correlated strongly between men and women, suggesting regional variation in GFR.

Conclusion

The CV of ECFV/BSA in normal subjects is a useful indicator of the technical robustness with which GFR is measured and, in this study, indicated a wide variation in departmental performance.

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References

  1. Bröchner-Mortensen J, Giese J, Rossing N. Renal inulin clearance versus total plasma clearance of 51Cr-EDTA. Scand J Clin Lab Invest 1969;23:301–5.

    Article  PubMed  Google Scholar 

  2. Cohen ML. Radionuclide clearance techniques. Semin Nucl Med 1974;4:23–38.

    Article  PubMed  CAS  Google Scholar 

  3. Chantler C, Garnett ES, Parsons V, Veall N. Glomerular filtration rate measurement in man by the single injection method using 51Cr-EDTA. Clin Sci 1969;37:169–80.

    PubMed  CAS  Google Scholar 

  4. Gaspari F, Perico N, Ruggenenti P, Mosconi L, Amuchastequi CS, Guerini E, et al. Plasma clearance of nonradioactive iohexol as a measure of glomerular filtration rate. J Am Soc Nephrol 1995;6:257–63.

    PubMed  CAS  Google Scholar 

  5. Peters AM. Expressing glomerular filtration rate in terms of extracellular fluid volume. Nephrol Dial Transplant 1992;7:205–10.

    PubMed  CAS  Google Scholar 

  6. Bird NJ, Michell AR, Peters AM. Accurate measurement of extracellular fluid volume from the slope/intercept technique after bolus injection of a filtration marker. Physiol Meas 2009;30:1371–9.

    Article  PubMed  Google Scholar 

  7. Cowley Jr AW, Roman RJ. Control of blood and extracellular volume. Baillieres Clin Endocrinol Metab 1989;3:331–69.

    Article  PubMed  Google Scholar 

  8. Skorecki KL, Brenner BM. Body fluid homeostasis in man. A contemporary overview. Am J Med 1981;70:77–88.

    Article  PubMed  CAS  Google Scholar 

  9. Peters AM. The kinetic basis of glomerular filtration rate measurement and new concepts of indexation to body size. Eur J Nucl Med Mol Imaging 2004;31:137–49.

    Article  PubMed  CAS  Google Scholar 

  10. Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr 1978;93:62–6.

    Article  PubMed  CAS  Google Scholar 

  11. Bröchner-Mortensen J. A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 1972;30:271–4.

    Article  PubMed  Google Scholar 

  12. Boer P. Estimated lean body mass as an index for normalization of body fluid volumes in man. Am J Physiol 1984;247:F632–5.

    PubMed  CAS  Google Scholar 

  13. Bird NJ, Peters C, Michell AR, Peters AM. Using the slope-only technique and estimated glomerular filtration rate for checking the reliability of slope-intercept measurement of glomerular filtration rate. Nucl Med Commun 2008;29:1086–92.

    Article  PubMed  Google Scholar 

  14. Vervoort G, Willems HL, Wetzels JFM. Assessment of glomerular filtration rate in healthy subjects and normoalbuminuric diabetic patients: validity of a new (MDRD) prediction equation. Nephrol Dial Transplant 2002;17:1909–13.

    Article  PubMed  CAS  Google Scholar 

  15. Bird NJ, Peters C, Michell AR, Peters AM. Association between glomerular filtration rate and extracellular fluid volume in normal subjects and patients with renal impairment. Scand J Clin Lab Invest 2008;68:39–49.

    Article  PubMed  CAS  Google Scholar 

  16. Simon AHR, Lima PRM, Almerinda M, Ribeiro Alves VF, Bottini PV, Lopes de Faria JB. Renal haemodynamic responses to a chicken or beef meal in normal individuals. Nephrol Dial Transplant 1998;13:2261–4.

    Article  PubMed  CAS  Google Scholar 

  17. Wesson LG. Renal hemodynamics in physiological states. In: Wesson LG, editor. Physiology of the human kidney. New York: Grune & Stratton; 1969. p. 96–108.

    Google Scholar 

  18. Poulsen HL, Jensen HE, Parving HH. Extracellular fluid volume determined by a single injection of inulin in men with untreated essential hypertension. Scand J Clin Lab Invest 1977;37:691–6.

    Article  PubMed  CAS  Google Scholar 

  19. Ladegaard-Pedersen HJ. Measurement of extracellular volume and renal clearance by a single injection of inulin. Scand J Clin Lab Invest 1972;29:145–53.

    Article  PubMed  CAS  Google Scholar 

  20. Bird NJ, Peters C, Michell AR, Peters AM. Comparison of GFR measurements assessed from single versus multiple samples. Am J Kidney Dis 2009;54:278–88.

    Article  PubMed  Google Scholar 

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Conflicts of interest

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Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Royal Sussex County Hospital, Audrey Emerton Building, Eastern Road, Brighton, BN2 5BE, UK

    A. Michael Peters & Hayley Snelling

  2. Department of Nuclear Medicine, Addenbrooke’s Hospital, Cambridge, UK

    Bethany Howard

  3. Department of Nuclear Medicine, Royal Liverpool University Hospital, Liverpool, UK

    Nagabhushan Seshadri

  4. Department of Nuclear Medicine, St Bartholomew’s Hospital, London, UK

    Ravin Sobnack

  5. Department of Nuclear Medicine, King’s College Hospital, London, UK

    Claire A. Hooker

  6. Department of Nuclear Medicine, St George’s Hospital, London, UK

    Andrew Irwin

  7. Department of Nuclear Medicine, Derriford Hospital, Plymouth, UK

    Thomas Gruning

  8. Department of Nuclear Medicine, Kent and Canterbury Hospital, Canterbury, UK

    Gregory Shabo

  9. Department of Nuclear Medicine, St Mary’s Hospital, London, UK

    Surendra Dave

  10. Department of Medical Physics, Royal Free Hospital, London, UK

    Laura Perry

  11. Department of Medical Physics, Manchester Royal Infirmary, Manchester, UK

    Richard S. Lawson

  12. Department of Medical Physics, University Hospital, Coventry, UK

    Nigel Williams

  13. Department of Medical Physics, St James’s University Hospital, Leeds, UK

    Mark C Barnfield

  14. Department of Medical Physics, Radiological Sciences Unit, Imperial College, London, UK

    Neva H. Patel

  15. Department of Medical Physics, University Medical Unit, Glasgow Royal Infirmary, Glasgow, UK

    Mark D. J. Neilly

Authors
  1. A. Michael Peters
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  2. Bethany Howard
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  3. Mark D. J. Neilly
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  4. Nagabhushan Seshadri
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  5. Ravin Sobnack
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  6. Claire A. Hooker
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  7. Andrew Irwin
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  8. Hayley Snelling
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  9. Thomas Gruning
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  10. Laura Perry
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  11. Neva H. Patel
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  12. Richard S. Lawson
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  13. Gregory Shabo
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  14. Nigel Williams
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  15. Surendra Dave
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  16. Mark C Barnfield
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Corresponding author

Correspondence to A. Michael Peters.

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Peters, A.M., Howard, B., Neilly, M.D.J. et al. The reliability of glomerular filtration rate measured from plasma clearance: a multi-centre study of 1,878 healthy potential renal transplant donors. Eur J Nucl Med Mol Imaging 39, 715–722 (2012). https://doi.org/10.1007/s00259-011-2024-5

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  • DOI: https://doi.org/10.1007/s00259-011-2024-5

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