Iohexol plasma clearance for measuring glomerular filtration rate in clinical practice and research: A review. Part 2: Why to measure glomerular filtration rate with iohexol?

Research output: Contribution to journalReview article

Abstract

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.

Details

Authors
Organisations
External organisations
  • University of Liège Hospital
  • UiT The Arctic University of Norway, Tromsø
  • Charité - University Medicine Berlin
  • Skåne University Hospital
  • Jean Monnet University
  • University of La Laguna (ULL)
  • Mario Negri Institute for Pharmacological Research
  • Uppsala University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Urology and Nephrology

Keywords

  • Glomerular filtration rate, Iohexol
Original languageEnglish
Pages (from-to)700-704
Number of pages5
JournalClinical Kidney Journal
Volume9
Issue number5
Publication statusPublished - 2016
Publication categoryResearch
Peer-reviewedYes