TY - JOUR
T1 - Iohexol plasma clearance for measuring glomerular filtration rate in clinical practice and research
T2 - A review. Part 2: Why to measure glomerular filtration rate with iohexol?
AU - Delanaye, Pierre
AU - Melsom, Toralf
AU - Ebert, Natalie
AU - Bäck, Sten Erik
AU - Mariat, Christophe
AU - Cavalier, Etienne
AU - Björk, Jonas
AU - Christensson, Anders
AU - Nyman, Ulf
AU - Porrini, Esteban
AU - Remuzzi, Giuseppe
AU - Ruggenenti, Piero
AU - Schaeffner, Elke
AU - Soveri, Inga
AU - Sterner, Gunnar
AU - Eriksen, Bjørn Odvar
AU - Gaspari, Flavio
PY - 2016
Y1 - 2016
N2 - A reliable assessment of glomerular filtration rate (GFR) is of paramount importance in clinical practice as well as epidemiological and clinical research settings. It is recommended by Kidney Disease: Improving Global Outcomes guidelines in specific populations (anorectic, cirrhotic, obese, renal and non-renal transplant patients) where estimation equations are unreliable. Measured GFR is the only valuable test to confirm or confute the status of chronic kidney disease (CKD), to evaluate the slope of renal function decay over time, to assess the suitability of living kidney donors and for dosing of potentially toxic medication with a narrowtherapeutic index. Abnormally elevated GFR or hyperfiltration in patients with diabetes or obesity can be correctly diagnosed only by measuring GFR. GFR measurement contributes to assessing the true CKD prevalence rate, avoiding discrepancies due to GFR estimation with different equations. Using measured GFR, successfully accomplished in large epidemiological studies, is the onlyway to study the potential link between decreased renal function and cardiovascular or total mortality, being sure that this association is not due to confounders, i.e. non-GFR determinants of biomarkers. In clinical research, it has been shown that measured GFR (or measured GFR slope) as a secondary endpoint as compared with estimated GFR detected subtle treatment effects and obtained these results with a comparatively smaller sample size than trials choosing estimated GFR. Measuring GFR by iohexol has several advantages: simplicity, low cost, stability and low interlaboratory variation. Iohexol plasma clearance represents the best chance for implementing a standardized GFR measurement protocol applicable worldwide both in clinical practice and in research.
AB - A reliable assessment of glomerular filtration rate (GFR) is of paramount importance in clinical practice as well as epidemiological and clinical research settings. It is recommended by Kidney Disease: Improving Global Outcomes guidelines in specific populations (anorectic, cirrhotic, obese, renal and non-renal transplant patients) where estimation equations are unreliable. Measured GFR is the only valuable test to confirm or confute the status of chronic kidney disease (CKD), to evaluate the slope of renal function decay over time, to assess the suitability of living kidney donors and for dosing of potentially toxic medication with a narrowtherapeutic index. Abnormally elevated GFR or hyperfiltration in patients with diabetes or obesity can be correctly diagnosed only by measuring GFR. GFR measurement contributes to assessing the true CKD prevalence rate, avoiding discrepancies due to GFR estimation with different equations. Using measured GFR, successfully accomplished in large epidemiological studies, is the onlyway to study the potential link between decreased renal function and cardiovascular or total mortality, being sure that this association is not due to confounders, i.e. non-GFR determinants of biomarkers. In clinical research, it has been shown that measured GFR (or measured GFR slope) as a secondary endpoint as compared with estimated GFR detected subtle treatment effects and obtained these results with a comparatively smaller sample size than trials choosing estimated GFR. Measuring GFR by iohexol has several advantages: simplicity, low cost, stability and low interlaboratory variation. Iohexol plasma clearance represents the best chance for implementing a standardized GFR measurement protocol applicable worldwide both in clinical practice and in research.
KW - Glomerular filtration rate
KW - Iohexol
UR - http://www.scopus.com/inward/record.url?scp=84995543569&partnerID=8YFLogxK
U2 - 10.1093/ckj/sfw071
DO - 10.1093/ckj/sfw071
M3 - Review article
C2 - 27679716
AN - SCOPUS:84995543569
SN - 2048-8505
VL - 9
SP - 700
EP - 704
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
IS - 5
ER -