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    Comparison of Iothalamate Clearance Methods for Measuring GFR

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    Author
    Dowling, Thomas C.
    Frye, Reginald F.
    Fraley, Donald S.
    Matzke, Gary R.
    Date
    1999
    Type
    Article
    
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    Abstract
    Study Objective. To evaluate the bias and precision of three methods of measuring glomerular filtration rate (GFR) relative to a standard method. Design. Prospective, outpatient study. Setting. University-affiliated general clinical research center. Patients. Twenty-six patients with various degrees of renal function (GFR range 25–151 ml/min/1.73 m2). Interventions. Each patient received iothalamate twice during the study visit, first as a bolus injection and then as a priming dose followed by a constantrate infusion for 2.5 hours. Measurements and Main Results. Plasma (ClpIVB) and renal clearances (ClrIVB) after bolus injection and plasma clearance during constant-rate infusion (ClpINF) were compared with standard renal clearance during constant-rate infusion (ClrINF). All three measures were highly correlated with ClrINF (r>0.90, p<0.001). The mean ClrIVB was not significantly different from ClrINF (106.3 ± 30.4 vs 104.2 ± 28.5 ml/min/1.73 m2) and provided a precise (8.8%, 95% CI 6.5–11.1%) and unbiased measure of GFR. Both ClpIVB and ClpINF were positively biased; values exceeded ClrINF by 11.8 ± 11.1 (p=0.0001) and 10.5 ± 12.5 ml/min/1.73 m2 (p=0.0003), respectively. Use of a nonrenal correction factor of 9.8 and 10.5 ml/min/1.73 m2 for infusion and bolus plasma clearance values, respectively, eliminated bias and improved the precision of these methods. Conclusions. Iothalamate renal clearance after bolus injection is a simple, accurate, and precise measurement of GFR and may be a useful alternative to the standard infusion method in clinical investigations. The corrected plasma clearance provides a simple index of GFR for clinical practice.
    Citation
    Dowling, T. C., Frye, R. F., Fraley, D. S., & Matzke, G. R. (1999). Comparison of iothalamate clearance methods for measuring GFR. Pharmacotherapy, 19(8), 943-950.
    Keyword
    Glomerular Filtration Rate
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/724
    ae974a485f413a2113503eed53cd6c53
    10.1592/phco.19.11.943.31576
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    Faculty, Student Works School of Pharmacy

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