Sinistrin clearance for determination of glomerular filtration rate: a reappraisal of various approaches using a new analytical method

Details

Serval ID
serval:BIB_4EB67937BDCA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Sinistrin clearance for determination of glomerular filtration rate: a reappraisal of various approaches using a new analytical method
Journal
Journal of Clinical Pharmacology
Author(s)
Buclin T., Pechere-Bertschi A., Sechaud R., Decosterd L. A., Munafo A., Burnier M., Biollaz J.
ISSN
0091-2700 (Print)
Publication state
Published
Issued date
08/1997
Volume
37
Number
8
Pages
679-92
Language
english
Notes
Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Aug
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.
Keywords
Adult Area Under Curve Female Glomerular Filtration Rate/*physiology Humans Kidney Function Tests/*instrumentation Male Models, Biological Oligosaccharides/administration & dosage/*diagnostic use/pharmacokinetics Regression Analysis
Pubmed
Web of science
Create date
25/01/2008 13:56
Last modification date
20/08/2019 15:04
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