Sinistrin clearance for determination of glomerular filtration rate: a reappraisal of various approaches using a new analytical method.
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Buclin, T, Pechère-Bertschi, A, Sechaud, Romain, Décosterd, L A, Munafo, A, Burnier, M and Biollaz, J (1997) Sinistrin clearance for determination of glomerular filtration rate: a reappraisal of various approaches using a new analytical method. Journal of clinical pharmacology, 37 (8). pp. 679-692. ISSN 0091-2700
Abstract
Several approaches are available to estimate the glomerular filtration rate (GFR) from the sinistrin clearance. To compare such approaches, GFR was estimated in six healthy volunteers, both after a bolus injection and a bolus dose followed by a 6-hour infusion. A recently developed high-performance liquid chromatography method was used for the determination of sinistrin levels, enabling precise measurements in plasma and urine samples with high sensitivity. Blood and urine were sampled up to 6 hours. Four calculation methods for estimating GFR were applied: 1) classical ratio of urinary excretion rate over plasma concentration (UV/P); 2) two-point (log-linear regression slope times monocompartmental volume of distribution) after bolus; 3) ratio of dose over area under the curve (D/AUC) after bolus; and 4) ratio of infusion rate over steady-state concentration during infusion (Rinf/P). The results obtained by fitting a pharmacokinetic model to all the plasma and urine data served as the standard against which the performance of the respective calculation methods were examined. The UV/P method performed poorly on bolus data, mainly by underestimating GFR at late times; on both bolus and infusion data, it suffered from important imprecisions on the urinary volume. The two-point method appeared applicable only between 2 and 4 hours after the bolus dose. The D/AUC method with extrapolation to infinity was highly reliable when integrating the concentrations up to 3 hours or more after the bolus dose. The Rinf/P method was satisfactory if applied later than 2 to 3 hours after the loading dose. The advantages and drawbacks of each method have to be evaluated in relation to the particular clinical setting in which GFR is to be estimated.
| Item Type: | Article |
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| Date Deposited: | 28 Jan 2012 00:45 |
| Last Modified: | 01 Feb 2013 00:46 |
| URI: | https://oak.novartis.com/id/eprint/5613 |