Estimation of glomerular filtration rate in dogs by a single-blood sample method involving iodixanol

Sasaki, Yui; Iwama, Ryosuke; Shimamura, Shunsuke; Katayama, Masaaki; Uzuka, Yuji; Yabe, Koichi; Takasuna, Kiyoshi; Satoh, Hiroshi; Furuhama, Kazuhisa

doi:10.2460/ajvr.76.9.828

Cited by 2 publications

(9 citation statements)

References 26 publications

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“…The GFR measured by the RS‐ and SS‐protocols proved reliable for many clinical situations regardless of the level of renal function. This is in agreement with previous reports that GFR assessed by simplified sampling approaches in companion animals correlates with GFR based on multi‐sample investigations …”

Section: Discussionsupporting

confidence: 93%

“…The most commonly used method to normalize GFR in dogs is indexation to BW, but some authors prefer to normalize the measurements to BSA, and differences have been reported between the levels of renal function standardized to BW or BSA . In the present study, we observed that the correlation between iohexol plasma clearance and dog body size was lost only when GFR was scaled to BW.…”

Section: Discussionmentioning

confidence: 99%

“…The iohexol concentrations in blood samples collected at 60, 90, or 180 minutes were used to derive the equations to predict GFR for the single‐sampling protocol (SS‐GFR: GFR 1 60, GFR 1 90, and GFR 1 180). We followed a 3‐step procedure, previously described . The procedure is based on the following Jacobsson formula:

italicGFR = \frac{1}{\frac{t}{Vd + 0.0016}} \times \ln \frac{Dose}{italicVd \times italicCt},

where Vd is the volume of distribution (mL) at sample collection time t (min), Ct the iohexol concentration measured at t , and dose is the amount of iohexol injected for each dog (mg/kg).…”

Section: Methodsmentioning

confidence: 99%

“…One major limitation is that conventional iohexol clearance protocols require repeated blood sampling over several hours, which is labor‐intensive, time‐consuming, and stressful for the animal. Numerous studies have attempted to determine the smallest number of blood samples needed for accurate GFR measurements in dogs and cats, and single‐point GFR methods have been investigated . However, most of these methods were not considered sufficiently reliable for CKD diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic potential of simplified methods for measuring glomerular filtration rate to detect chronic kidney disease in dogs

Pocar

Scarpa

Berrini

et al. 2019

Veterinary Internal Medicne

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Background Glomerular filtration rate (GFR) is the most sensitive indicator of initial renal function decline during chronic kidney disease (CKD), but conventional protocols for measuring GFR are labor‐intensive and stressful for the dog. Objectives To assess the diagnostic potential for detecting CKD with simplified GFR protocols based on iohexol plasma clearance. Animals Seventeen CKD‐positive and 23 CKD‐negative dogs of different breeds and sex. Methods Prospective nonrandomized study. Plasma iohexol was measured 5, 15, 60, 90, and 180 minutes after injection. Glomerular filtration rate was calculated using 5 samples (GFR5) or simplified protocols based on 1, 2, or 3 samples. The GFR5 and simplified GFR were compared by Bland‐Altmann and concordance correlation coefficient (CCC) analysis, and diagnostic accuracy for CKD by receiver operating characteristic curves. A gray zone for each protocol was bounded by the fourth quartile of the CKD‐positive population (lower cutoff) and the first quartile of the CKD‐negative population (upper cutoff). Results All simplified protocols gave reliable GFR measurements, comparable to reference GFR5 (CCC >0.92). Simplified protocols which included the 180‐minutes sampling granted the best GFR measure (CCC: 0.98), with strong diagnostic potential for CKD (area under the receiver operating characteristic curve ± SE: 0.98 ± 0.01). A double cutoff including a zone of CKD uncertainty guaranteed reliable diagnosis outside the gray area and identified borderline dogs inside it. Conclusions The simplified GFR protocols offer an accurate, hands‐on tool for CKD diagnosis in dogs. The gray zone might help decision‐making in the management of early kidney dysfunction.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

italicGFR = \frac{1}{\frac{t}{Vd + 0.0016}} \times \ln \frac{Dose}{italicVd \times italicCt},

where Vd is the volume of distribution (mL) at sample collection time t (min), Ct the iohexol concentration measured at t , and dose is the amount of iohexol injected for each dog (mg/kg).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic potential of simplified methods for measuring glomerular filtration rate to detect chronic kidney disease in dogs

Pocar

Scarpa

Berrini

et al. 2019

Veterinary Internal Medicne

View full text Add to dashboard Cite

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“…Thus, strategies to reduce the number of sampling have been exploited as first reported by Bröchner-Mortensen (1972) in humans. All of these foresaw the addition of correction formulas to achieve more accurate GFR estimation ( Gleadhill and Michell 1996 ; Bexfield et al, 2008 ; Von Hendy-Willson and Pressler 2011 ; Sasaki et al, 2015 ; Pocar et al, 2019 ). Nevertheless, from veterinary practitioners there is still a demand for reliable and easily applicable GFR estimations methods in a clinical setting.…”

Section: Introductionmentioning

confidence: 99%

Population Pharmacokinetic Model of Iohexol in Dogs to Estimate Glomerular Filtration Rate and Optimize Sampling Time

et al. 2021

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Monitoring iohexol plasma clearance is considered a useful, reliable, and sensitive tool to establish glomerular filtration rate (GFR) and early stages of kidney disease in both humans and veterinary medicine. The assessment of GFR based on iohexol plasma clearance needs repeated blood sampling over hours, which is not easily attainable in a clinical setting. The study aimed to build a population pharmacokinetic (Pop PK) model to estimate iohexol plasma clearance in a population of dogs and based on this model, to indicate the best sampling times that enable a precise clearance estimation using a low number of samples. A Pop PK model was developed based on 5 iohexol plasma samples taken from 5 to 180 minutes (min) after an intravenous iohexol nominal dose of 64.7 mg/kg from 49 client-owned dogs of different breeds, sexes, ages, body weights, and clinical conditions (healthy or presenting chronic kidney disease CKD). The design of the best sampling times could contain either 1 or 2 or 3 sampling times. These were discretized with a step of 30 min between 30 and 180 min. A two-compartment Pop PK model best fitted the data; creatinine and kidney status were the covariates included in the model to explain a part of clearance variability. When 1 sample was available, 90 or 120 min were the best sampling times to assess clearance for healthy dogs with a low creatinine value. Whereas for dogs with CKD and medium creatinine value, the best sampling time was 150 or 180 min, for CKD dogs with a high creatinine value, it was 180 min. If 2 or 3 samples were available, several sampling times were possible. The method to define the best sampling times could be used with other Pop PK models as long as it is representative of the patient population and once the model is built, the use of individualized sampling times for each patient allows to precisely estimate the GFR.

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Estimation of glomerular filtration rate in dogs by a single-blood sample method involving iodixanol

Abstract: Results indicated that the SBSM involving iodixanol can be applied to estimate GFR in dogs, instead of use of an MBSM.

Cited by 2 publications

References 26 publications

Diagnostic potential of simplified methods for measuring glomerular filtration rate to detect chronic kidney disease in dogs

Diagnostic potential of simplified methods for measuring glomerular filtration rate to detect chronic kidney disease in dogs

Population Pharmacokinetic Model of Iohexol in Dogs to Estimate Glomerular Filtration Rate and Optimize Sampling Time

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