2013
DOI: 10.1007/s00467-013-2426-7
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Methods of assessing renal function

Abstract: Accurate assessment of renal function is critical for appropriate drug dosing of renally excreted compounds. Glomerular filtration rate (GFR) is considered the best marker of kidney function. Inulin clearance forms the gold standard for measuring GFR, both in adults and in children. The method is invasive, cumbersome, and smaller children require urinary catheterization for accurate timed urine collections. Nuclear medicine methods replaced inulin clearance in the 1970s after (51)Cr EDTA clearance was introduc… Show more

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Cited by 91 publications
(94 citation statements)
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“…It can be argued that there may be a slight underestimation of GFR by ϳ10% using 51 Cr-EDTA in the present study. This is due to a small amount (12.15 Ϯ 0.59%) of 51 Cr-EDTA is plasma protein bound, and, consequently, this may affect their ultrafiltration (8,13). However, in the present experimental setup, arterial 51 Cr-EDTA levels were constant during the experiments, implying that also the protein-bound fraction of 51 Cr-EDTA must have been constant.…”
Section: Discussionmentioning
confidence: 52%
“…It can be argued that there may be a slight underestimation of GFR by ϳ10% using 51 Cr-EDTA in the present study. This is due to a small amount (12.15 Ϯ 0.59%) of 51 Cr-EDTA is plasma protein bound, and, consequently, this may affect their ultrafiltration (8,13). However, in the present experimental setup, arterial 51 Cr-EDTA levels were constant during the experiments, implying that also the protein-bound fraction of 51 Cr-EDTA must have been constant.…”
Section: Discussionmentioning
confidence: 52%
“…Although nuclear medicine tests replaced inulin clearance worldwide in the 1970s, all nuclear medicine methods use tracers that have some plasma protein binding. This binding is low on average but shows significant variability (32). The results from this study were also formed as part of a post hoc analysis of a study that was designed for a different purpose, namely to show the superiority of CysC versus Cr as a surrogate endogenous GFR marker (33).…”
Section: Discussionmentioning
confidence: 99%
“…Many centers only use two sampling points instead of three and start sampling before the intravascular and extravascular spaces are equilibrated (32). Other strengths of the study include its large sample size (755 patients), broad age range of pediatric patients (2-17.9 years old), wide variety of renal pathologies, and wide range of GFR values within the cohort.…”
Section: Discussionmentioning
confidence: 99%
“…Serum creatinine levels in children are much lower than in adults because they have less muscle mass, and the appropriate normal range for age must be used (Schwartz et al 1976). GFR calculation should be done with equations adapted to be suitable for young pediatric patients (Filler et al 2013, Langlois 2008Ring et al 2008, Schwartz andWork 2008;Schwartz et al 2009). …”
Section: Indicationsmentioning
confidence: 98%