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Chromium-51-EDTA clearance in adults with a single-plasma sample
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.
1998 (English)In: Journal of Nuclear Medicine, ISSN 0161-5505, E-ISSN 1535-5667, Vol. 39, no 12, 2131-2137 p.Article in journal (Refereed) Published
Abstract [en]

In 1996, a committee on renal clearance recommended a mean sojourn time-based methodology for single-sample determination of plasma clearance of 99mTc-diethylenetriamine pentaacetic acid (DTPA) to be used on adults if the patient's glomerular filtration rate (GFR) is suspected to be >30 ml/min. The main purpose of this study was to derive a mean sojourn time-based formula for calculation of 51Cr-ethylenediamine tetraacetic acid (EDTA) clearance in adults.

Methods: Two groups of patients with 51Cr-EDTA clearance (CI) between 16 and 172 ml/min were studied. In Group I (n = 46), reference CI was determined as a multi plasma sample, single-injection method (CISM). Sixteen blood samples were drawn from 0 until 5 hr after a single intravenous injection of 51Cr-EDTA. In Group II (n = 1046), reference CI was determined by the Brøchner-Mortensen four-sample clearance method (CIBM). The plasma timeactivity curves of Group I were used to derive two mean sojourn time-based formulas (Formulas 1 and 2) for calculation of a single sample clearance. Formula 1 was derived from the entire time activity curve, whereas the derivation of Formula 2 used only the final slope of the time-activity curve. The accuracy of the two formulas and the Christensen and Groth 99mTc-DTPA formula was tested on Group II.

Results: Chromium-51-EDTA CI calculated by Formula 1 was almost identical to the CI calculated by the reference CI method (r = 0.982; SDdiff = 5.82 ml/min). Both 51Cr-EDTA CI calculated by Formula 2 and by the 99mTc-DTPA formula showed close correlation with the reference method (r = 0.976, r = 0.985, respectively) but systematically overestimated GFR for the whole range of clearance values by 3.5 and 3.2 ml/min (p < 0.001), respectively.

Conclusion: It is possible to get an accurate determi nation of 51Cr-EDTA CI from a single-plasma sample in adults by the mean sojourn time methodology. The determination is marginally more accurate (p < 0.001) if using a formula derived from the entire plasma time-activity curve than from only the final slope. The single-sample formula derived for determination of 99mTc-DTPA CI tends slightly to overestimate GFR if used to calculate 51Cr-EDTA CI.

Place, publisher, year, edition, pages
1998. Vol. 39, no 12, 2131-2137 p.
Keyword [en]
single sample, chromium-51-ethylenediaminetetraacetic acid clearance, glomerular filtration rate, renal function
URN: urn:nbn:se:umu:diva-40234OAI: diva2:398574
Available from: 2011-02-18 Created: 2011-02-18 Last updated: 2011-04-12Bibliographically approved
In thesis
1. Glomerular filtration rate in adults: a single sample plasma clearance method based on the mean sojurn time
Open this publication in new window or tab >>Glomerular filtration rate in adults: a single sample plasma clearance method based on the mean sojurn time
2011 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Glomerular filtration rate (GFR) is a key parameter in evaluating kidney function. After a bolus injection of an exogenous GFR marker in plasma an accurate determination of GFR can be made by measuring the marker concentration in plasma during the excretion. Simplified methods have been developed to reduce the number of plasma samples needed and yet still maintain a high accuracy in the GFR determination. Groth previously developed a single sample GFR method based on the mean sojourn time of a GFR marker in its distribution volume. This method applied in adults using the marker 99m Tc-DTPA is recommended for use when GFR is estimated to be ≥ 30 mL/min. The aim of the present study was to further develop the single plasma sample GFR method by Groth including patients with severely reduced renal function and different GFR markers. Three different GFR markers 51Cr-EDTA, 99mTc-DTPA and iohexol were investigated. Formulas were derived for the markers 51Cr-EDTA and iohexol when GFR is estimated to be ≥ 30 mL/min. For patients with an estimated GFR < 30 mL/min a special low clearance formula with a single sample obtained about 24 h after marker injection was developed. The low clearance formula was proven valid for use with all three markers. The sources of errors and their influence on the calculated single sample clearance were investigated. The estimated distribution volume is the major source of error but its influence can be reduced by choosing a suitable sampling time. The optimal time depends on the level of GFR; the lower GFR the later the single sample should be obtained. For practical purpose a 270 min sample is recommended when estimated GFR ≥ 30 mL/min and a 24 h sample when estimated GFR < 30 mL/min. Sampling at 180 min after marker injection may be considered if GFR is estimated to be essentially normal.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 53 p.
, Licentiatuppsats, Klinisk fysiologi
Research subject
Clinical Physiology
urn:nbn:se:umu:diva-42319 (URN)978-91-7459-158-3 (ISBN)
2011-05-12, Biblioteket, Enheten för klinisk fysiologi, våning 1, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Available from: 2011-04-12 Created: 2011-04-07 Last updated: 2011-04-12Bibliographically approved

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