Iohexol plasma clearance in children: validation of multiple formulas and single-point sampling times. 2018

Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
Department of Pediatrics, Haukeland University Hospital, 5021, Bergen, Norway. camilla.tondel@helse-bergen.no.

The non-ionic agent iohexol is increasingly used as the marker of choice for glomerular filtration rate (GFR) measurement. Estimates of GFR in children have low accuracy and limiting the number of blood-draws in this patient population is especially relevant. We have performed a study to evaluate different formulas for calculating measured GFR based on plasma iohexol clearance with blood sampling at only one time point (GFR1p) and to determine the optimal sampling time point. Ninety-six children with chronic kidney disease (CKD) stage 1-5 (median age 9.2 years; range 3 months to 17.5 years) were examined in a cross-sectional study using iohexol clearance and blood sampling at seven time points within 5 h (GFR7p) as the reference method. Median GFR7p was 66 (range 6-153) mL/min/1.73 m2. The performances of six different single time-point formulas (Fleming, Ham and Piepsz, Groth and Aasted, Stake, Jacobsson- and Jacobsson-modified) were validated against the reference. The two-point GFR (GFR2p) was calculated according to the Jødal and Brøchner-Mortensen formula. The GFR1p calculated according to Fleming with sampling at 3 h (GFR1p3h-Fleming) had the best overall performance, with 82% of measures within 10% of the reference value (P10). In children with a GFR ≥ 30 mL/min/1.73 m2 (n = 78), the GFR1p3h-Fleming had a P10 of 92.3%, which is not significantly different (p = 0.29) from that of GFR2p (P10 = 96.2%). Considerable differences within and between the different formulas were found for different CKD stages and different time points for blood sampling. For determination of mGFR in children with CKD and an assumed GFR of ≥ 30 mL/min/1.73 m2 we recommend GFR1p3h-Fleming as the preferred single-point method as an alternative to GFR2p. For children with a GFR < 30 mL/min/1.73 m2, we recommend the slope-GFR with at least two blood samples. ClinicalTrials.gov , Identifier NCT01092260, https://clinicaltrials.gov/ct2/show/NCT01092260?term=tondel&rank=2.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007472 Iohexol An effective non-ionic, water-soluble contrast agent which is used in myelography, arthrography, nephroangiography, arteriography, and other radiographic procedures. Its low systemic toxicity is the combined result of low chemotoxicity and low osmolality. Compound 545,Exypaque,Iohexol 350,Nycodenz,Omnipaque
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D008297 Male Males
D008657 Metabolic Clearance Rate Volume of biological fluid completely cleared of drug metabolites as measured in unit time. Elimination occurs as a result of metabolic processes in the kidney, liver, saliva, sweat, intestine, heart, brain, or other site. Total Body Clearance Rate,Clearance Rate, Metabolic,Clearance Rates, Metabolic,Metabolic Clearance Rates,Rate, Metabolic Clearance,Rates, Metabolic Clearance
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D005260 Female Females
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration

Related Publications

Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
March 1996, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
October 1998, Clinica chimica acta; international journal of clinical chemistry,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
November 2022, European journal of pediatrics,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
July 2018, BMC nephrology,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
February 2021, Clinical chemistry and laboratory medicine,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
May 2016, American journal of kidney diseases : the official journal of the National Kidney Foundation,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
December 2022, European journal of pediatrics,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
May 2016, American journal of kidney diseases : the official journal of the National Kidney Foundation,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
March 2010, The Journal of veterinary medical science,
Camilla Tøndel, and Cathrin Lytomt Salvador, and Karl Ove Hufthammer, and Bjørn Bolann, and Damien Brackman, and Anna Bjerre, and Einar Svarstad, and Atle Brun
May 2024, Pediatric nephrology (Berlin, Germany),
Copied contents to your clipboard!