Reference standard analysis of multiple new and old plasma clearance models and renal clearance with special attention to measurement of reduced glomerular filtration rate.
Scand J Clin Lab Invest
; 83(8): 548-568, 2023 Dec.
Article
em En
| MEDLINE
| ID: mdl-38219224
ABSTRACT
Nine models were evaluated as candidate glomerular filtration rate (GFR) reference standards in three datasets using [51Cr(EDTA)]- or [169Yb(DTPA)]2- anions in 98 studies. Noncompartmental methods formed an upper limit for estimating mass excreted and voluntary urine collection formed a lower limit. For current models and methods, reduced GFR in adults resulted in inflated clearance estimates. Two different logarithmic models with exponential tails were created and may have underestimated reduced clearance. The logarithmic formulae can be used with only two plasma samples, and fit 13 multiple time-samples from 5 min to 24 h with an 8% standard deviation of residuals compared to 20% error for monoexponentials. For shorter times (4 or 5 h) the fit errors decreased but the ratio of errors remained at circa 2.5 times lesser for the logarithmic versus monoexponential models. Adaptively regularised gamma variate, Tk-GV, models that are well documented, but not in common use, were largely contained within the reference extreme values, were unbiased for different levels of clearance and were the only models to be uncorrelated to volume of distribution from mean residence time divided by weight. Using Tk-GV as a candidate reference standard, potentially better methods for routine clinical usage were discussed. Prospective clinical testing, and metabolic scaling of decreased renal function is advised for potential changes to patient triage.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pentetato de Tecnécio Tc 99m
/
Compostos Radiofarmacêuticos
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Scand J Clin Lab Invest
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Canadá