Reference data for 51Cr-EDTA measurements of the glomerular filtration rate derived from live kidney donors

Grewal, Gurmandeep S; Blake, Glen M.

doi:10.1097/00006231-200501000-00010

Cited by 102 publications

(84 citation statements)

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“…An increased prevalence of renal dysfunction has also been found amongst female patients in other studies of CV risk [5-11, 13, 14], and has usually been related to the fact that women are older than men in patient populations with MI and acute coronary syndromes. There was, however, no age difference between men and women in the present study, and there is no gender-related difference in renal function amongst healthy individuals [21,22]. There is a correction for gender-related differences in the Cockcroft-Gault formula due to the lower muscle mass and creatinine production amongst women [18], but the equation may nonetheless be less precise amongst women.…”

Section: Discussioncontrasting

confidence: 56%

Prognostic implications of renal dysfunction in patients with stable angina pectoris

Almquist

Forslund

Rehnqvist

et al. 2006

Journal of Internal Medicine

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Objective. Impaired renal function is emerging as an independent risk factor for cardiovascular (CV) disease. We analysed the prognostic implications of estimated renal function in patients with angina pectoris. Design. Post hoc analysis of the Angina Prognosis Study In Stockholm (APSIS). The estimated creatinine clearance (eCrCl) was calculated according to the Cockcroft-Gault formula in 808 patients. Outcomes were compared for subgroups with CrCl ‡90, 60-89 and<60 mL min )1 . Setting. Hospital-based study with patients referred from primary care and hospital. Subjects. A total of 809 patients (248 women) with clinically diagnosed stable angina pectoris. Intervention. Double-blind treatment with metoprolol or verapamil.Results. One hundred and sixty-four patients (91 women) had an eCrCl below 60 mL min )1 . During a median follow-up of 40 months, 38 patients suffered CV death and 31 patients had a nonfatal myocardial infarction (MI). In a univariate analysis a lower eCrCl was related to a higher risk for CV death or MI amongst men (log rank P ¼ 0.036). A multivariate Cox analysis showed an independent prognostic importance of eCrCl for CV death (P ¼ 0.046) and for CV death or MI (P ¼ 0.042) amongst all patients. When analysed as a continuous variable, a 1 mL min )1 decrease in eCrCl was associated with a 1.6% (0.1-3.1) increase in the risk for CV death or MI, and a 2.1% (0-4.1) increase in the risk for CV death alone. Conclusion. Renal dysfunction was found to be common in patients with stable angina pectoris and estimated creatinine clearances carried significant independent prognostic information regarding CV death and nonfatal MI.

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Section: Discussioncontrasting

confidence: 56%

Prognostic implications of renal dysfunction in patients with stable angina pectoris

Almquist

Forslund

Rehnqvist

et al. 2006

Journal of Internal Medicine

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“…Other authors described the same variation for 51 Cr-EDTA-Cl ranging from 3.9% to 11.6% [17,[52][53][54]. In summary, we showed that plasma 51 Cr-EDTA-Cl is a very precise method to measure GFR in renal transplanted recipients.…”

Section: Discussionsupporting

confidence: 80%

Validation of plasma clearance of⁵¹Cr-EDTA in adult renal transplant recipients: comparison with inulin renal clearance

Medeiros¹,

Sapienza²,

Prado³

et al. 2009

Transplant International

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Summary Plasma clearance of 51Cr‐EDTA (51Cr‐EDTA‐Cl) is an alternative method to evaluate glomerular filtration rate (GFR). This study aimed to investigate the concordance between 51Cr‐EDTA‐Cl and renal inulin clearance (In‐Cl) in renal transplant recipients as well to determine the repeatability of 51Cr‐EDTA‐Cl in kidney donors. Forty four kidney recipients and 22 kidney donors were enrolled. Simultaneous measurements of 51Cr‐EDTA‐Cl and In‐Cl were performed. A single dose of 3.7MBq of 51Cr‐EDTA was injected and the plasma disappearance curve was created by taking blood samples at 2, 4, 6 and 8 h after injection. Bland and Altman statistical approach was used to quantify the agreement between In‐Cl and 51Cr‐EDTA‐Cl and to determine the better concordance between all possibilities of measure for the 51Cr‐EDTA‐Cl. The mean of In‐Cl was 44.5 ± 17.9 ml/min/1.73 m2. There was a positive correlation between In‐Cl and all possible measurements of 51Cr‐EDTA‐Cl. 51Cr‐EDTA‐Cl with two samples taken at 4 and 8 h or at 4 and 6 h presenting the narrow limits of agreement and a difference (bias) of 2.8 and 2.7 ml/min, respectively. Two plasma sampling for 51Cr‐EDTA‐Cl was a reliable method to measure GFR compared with In‐Cl and comprises a suitable method to be used in kidney transplanted patients.

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“…Although the effect size was modest, each 1 SD higher CFPWV was associated with lower GFR roughly equivalent to 2 years of aging. 22 The persistence of an association between GFR and CFPWV in the absence of comparable relations between GFR and MAP or CPP suggests that aortic stiffness (as assessed by CFPWV) may be an important therapeutic target for the maintenance of adequate kidney function even beyond the potential beneficial effects of BP control.…”

Section: Discussionmentioning

confidence: 99%

Mediation Analysis of Aortic Stiffness and Renal Microvascular Function

Woodard

Sigurðsson

Gotal

et al. 2015

Journal of the American Society of Nephrology

105

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Aortic stiffening, assessed by carotid-femoral pulse wave velocity, is associated with CKD. Transmission of excessive flow pulsatility into the low-impedance renal microvasculature may mediate this association. However, direct analyses of macrovascular-microvascular relations in the kidney are limited. Using arterial tonometry, iohexol clearance, and magnetic resonance imaging, we related arterial stiffness, GFR, urinary albumin excretion, and potential mediators, including renal artery pulsatility index, renal vascular resistance, and arterial volume in the cortex, in 367 older adults (ages 72-92 years) participating in the Age, Gene/ Environment Susceptibility-Reykjavik Study. In a model adjusted for age, sex, heart rate, and body size, aortic stiffness was related to GFR (Slope of regression B=22.2860.85 ml/min per SD, P=0.008) but not urine albumin (P=0.09). After accounting for pulsatility index, the relation between aortic stiffness and GFR was no longer significant (P=0.10). Mediation analysis showed that 34% of the relation between aortic stiffness and GFR was mediated by pulsatility index (95% confidence interval of indirect effect, 21.35 to 20.29). An additional 20% or 36% of the relation was mediated by lower arterial volume in the cortex or higher renal vascular resistance, respectively, when offered as mediators downstream from higher pulsatility index (95% confidence interval of indirect effect including arterial volume in the cortex, 22.22 to 20.40; 95% confidence interval of indirect effect including renal vascular resistance, 22.51 to 20.76). These analyses provide the first evidence that aortic stiffness may contribute to lower GFR by transferring excessive flow pulsatility into the susceptible renal microvasculature, leading to dynamic constriction or vessel loss.

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Reference data for 51Cr-EDTA measurements of the glomerular filtration rate derived from live kidney donors

Cited by 102 publications

References 10 publications

Prognostic implications of renal dysfunction in patients with stable angina pectoris

Prognostic implications of renal dysfunction in patients with stable angina pectoris

Validation of plasma clearance of⁵¹Cr-EDTA in adult renal transplant recipients: comparison with inulin renal clearance

Mediation Analysis of Aortic Stiffness and Renal Microvascular Function

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Reference data for 51Cr-EDTA measurements of the glomerular filtration rate derived from live kidney donors

Cited by 102 publications

References 10 publications

Prognostic implications of renal dysfunction in patients with stable angina pectoris

Prognostic implications of renal dysfunction in patients with stable angina pectoris

Validation of plasma clearance of51Cr-EDTA in adult renal transplant recipients: comparison with inulin renal clearance

Mediation Analysis of Aortic Stiffness and Renal Microvascular Function

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Product

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Validation of plasma clearance of⁵¹Cr-EDTA in adult renal transplant recipients: comparison with inulin renal clearance