Measurement of Glomerular Filtration Rate

Warwick, James; Holness, Jennifer L

doi:10.1053/j.semnuclmed.2021.12.005

Cited by 22 publications

(28 citation statements)

References 101 publications

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“…This is an important consideration for a future trial. The renal function of participants was estimated using the calculated GFR; however, the gold standard measurement of renal function involves the injection of a tracer and its clearance by the kidneys (56). A single 24-h recall was used to estimate protein intakes.…”

Section: Discussionmentioning

confidence: 99%

Serum creatinine as an indicator of lean body mass in vegetarians and omnivores

2022

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Growing numbers of Americans are adopting vegetarian or vegan diets. While risk for some chronic conditions may be lower when following these diets, concern remains over the ability to consume adequate amounts of various nutrients, notably, protein. Knowing that serum creatinine is a reliable marker of muscle mass, this study examined the relationships between serum creatinine, lean body mass (LBM), handgrip strength, and protein intake in healthy vegetarian (n = 55) and omnivorous (n = 27) adults. Significantly higher protein intakes (+31%), LBM (+7%), serum creatinine (+12%) and handgrip strength (+14%) were observed for the omnivore participants compared to vegetarian participants. Positive correlations (p < 0.001) were noted between creatinine and LBM (R2 = 0.42), creatinine and handgrip strength (R2 = 0.41), protein intake and LBM (R2 = 0.29), and handgrip strength and LBM (R2 = 0.69). These data show that serum creatinine concentrations were lower in vegetarian women and men in comparison to their omnivorous counterparts and that serum creatinine concentrations correlate with LBM and strength in healthy adults, regardless of diet.

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Section: Discussionmentioning

confidence: 99%

Serum creatinine as an indicator of lean body mass in vegetarians and omnivores

2022

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“…In this section, a qualitative description is given of the methods used to measure GFR. A more mathematically detailed summary is available in a recent review [32]. These methodologies remain equally valid whether the tracer is a radiopharmaceutical measured using a well counter or a non-radiopharmaceutical tracer measured using alternative techniques.…”

Section: Methods Of Measuring Gfrmentioning

confidence: 99%

“…Using images of the full and empty syringe and a population-based correction for kidney depth, the percentage of renal uptake of 99 mTc-DTPA is empirically correlated with GFR. Further refinements of this technique use an exponential instead of a linear function, individualized measurements of kidney depth, the inclusion of bladder imaging and the use of alternative mathematical techniques [32]. Evaluations against plasma sampling methods have generally found this approach to be imprecise [32].…”

Section: Gamma Camera-based Methodsmentioning

confidence: 99%

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Measurement of glomerular filtration rate and its current status in African countries GFR measurement and its status in Africa

Holness¹,

Westhuizen²,

Davids³

et al. 2022

AJN

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Glomerular filtration rate (GFR) is usually estimated rather than measured as this only requires measurement of an endogenous filtration marker. In certain clinical settings a more accurate measure of GFR is essential. The most commonly used endogenous filtration marker is creatinine. Exogenous filtration markers include nonradiopharmaceuticals such as inulin, iohexol and unlabelled iothalamate, or radiopharmaceuticals such as 51Crethylenediaminetetraacetic acid (51Cr-EDTA) and 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA). Inulin is considered an ideal filtration marker but the clearance of iothalamate, 99mTc-DTPA, 51Cr-EDTA and iohexol have all been shown to have sufficient accuracy for measuring GFR. For radiopharmaceuticals, a well counter is required to measure the amount of activity in patient samples. Iohexol or unlabelled iothalamate require samples to be measured using high performance liquid chromatography with ultraviolet detection (HPLC-UV), liquid chromatography-tandem mass spectrometry (LC-MS/MS) or x-ray fluorescence (XRF). Due to the practical challenges of measuring urinary clearance, measurement of GFR in clinical settings is almost exclusively based on plasma clearance of a filtration marker. This can follow a long-established approach based on the ratio of the tracer administered to the area under the plasma concentration curve. Alternatively, a single plasma sample giving an apparent volume of distribution at a given time point can be used to accurately measure GFR. While techniques exist for the measurement of GFR in a number of African countries, preliminary evidence suggests that facilities are very limited. There is a need for support for both equipment and training to establish GFR measurement facilities in several centres on the continent. Keywords: measured glomerular filtration rate;, mGFR;, Africa

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“…The most commonly used isotope for measurement of iGFR is 51Cr-EDTA and 99mTc-DTPA, with clearance rates comparable to non-radiopharmaceutical markers such as inulin, iohexol, and iothalamate. 3 Importantly, this method enables the detection of unilateral renal blood flow and kidney function, with more details available from the time-uptake curve. The whole procedure is non-invasive and does not require collecting blood and urine, taking approximately 20 min, and is not subject to interference by the diet.…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Sporadic Renal Cysts and Renal Function Detected by Isotope Renography in Type 2 Diabetes

Li¹,

Lou²,

Su³

et al. 2022

DMSO

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Purpose This study aimed to reveal the relationship between the volume of sporadic renal cysts and renal function in patients with type 2 diabetes (T2D). Materials and Methods One hundred and seventy-one patients that underwent renal imaging and other routine examinations at the Shanghai Pudong Hospital were included in this study. The Gates’ method of glomerular filtration rate (GFR) was measured by 99m Tc-DTPA renal dynamic imaging in addition to the eGFR, calculated by the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI). Results Our results showed that BMI, total iGFR, and eGFR showed significant differences between patients with T2D with or without SRC (p < 0.05). Spearman correlation analysis showed that cyst volume was positively correlated with Scr and gender but not iGFR (p > 0.05). The total iGFR positively correlated with eGFR (r = 0.83, p < 0.0001) and negatively with Scr (r = −0.78, p < 0.0001), age (r = −0.43, p < 0.0001), duration of T2D (r = −0.25, p = 0.001), and BMI (r = −0.21, p = 0.006) but not gender (r = −0.03, p = 0.668). The multilinear regression model revealed that gender (β = 0.346, p < 0.001), iGFR (β = −0.705, p < 0.001), and serum uric acid (β = 0.195, p = 0.032) were independent predictors of Scr. Moreover, we observed a significant increase in Scr in males (p < 0.05). Finally, we found that the split kidney function reflected by iGFR and related parameters such as time to peak (PTT) and half time of excretion (excrete t1/2) did not mutually distinguish from each other significantly whether they are measured in patients with renal cysts or in those without renal cysts (p > 0.05). Conclusion Our preliminary results suggest that in T2D, SRCs may be a renal complication of diabetic nephropathy. Although we found that the patients with renal cysts may display reduced iGFR, the volume of simple cysts seems not to exacerbate renal insufficiency. Isotope renography is a useful tool to evaluate the split kidney functions in diabetic patients who acquire single-side cysts.

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Measurement of Glomerular Filtration Rate

Cited by 22 publications

References 101 publications

Serum creatinine as an indicator of lean body mass in vegetarians and omnivores

Serum creatinine as an indicator of lean body mass in vegetarians and omnivores

Measurement of glomerular filtration rate and its current status in African countries GFR measurement and its status in Africa

Relationship Between Sporadic Renal Cysts and Renal Function Detected by Isotope Renography in Type 2 Diabetes

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