Mannitol clearance for the determination of glomerular filtration rate–a validation against clearance of 51Cr-EDTA

Katalin Kiss, Miklós Molnár, Sören Söndergaard, Gyula Molnár, Sven Erik Ricksten

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Abstract

We studied the agreement between plasma clearance of mannitol and the reference method, plasma clearance of 51Cr-EDTA in outpatients with normal to moderately impaired renal function. Forty-one patients with a serum creatinine <200 μmol l−1 entered the study. 51Cr-EDTA clearance was measured with the standard bolus injection technique and glomerular filtration rate (GFR) was calculated by the single-sample method described by Jacobsson. Mannitol, 0·25 g kg−1 body weight (150 mg ml−1), was infused for 4–14 min and blood samples taken at 1-, 2-, 3- and 4-h (n = 24) or 2-, 3-, 3·5- and 4-h after infusion (n = 17). Mannitol in serum was measured by an enzymatic method. Plasma clearance for mannitol and its apparent volume of distribution (Vd) were calculated according to Brøchner-Mortensen. Mean plasma clearance (±SD) for 51Cr-EDTA was 59·7 ± 18·8 ml min−1. The mean plasma clearance for mannitol ranged between 57·0 ± 20·1 and 61·1 ± 16·7 ml min−1 and Vd was 21·3 ± 6·2% per kg b.w. The between-method bias ranged between −0·23 and 2·73 ml min−1, the percentage error between 26·7 and 39·5% and the limits of agreement between −14·3/17·2 and −25·3/19·9 ml min−1. The best agreement was seen when three- or four-sample measurements of plasma mannitol were obtained and when sampling started 60 min after injection. Furthermore, accuracy of plasma clearance determinations was 88–96% (P30) and 41–63% (P10) and was highest when three- or four-sample measurements of plasma mannitol were obtained, including the first hour after the bolus dose. We conclude that there is a good agreement between plasma clearances of mannitol and 51Cr-EDTA for the assessment of GFR.

Original languageEnglish
Pages (from-to)10-16
Number of pages7
JournalClinical Physiology and Functional Imaging
Volume38
Issue number1
DOIs
Publication statusPublished - Jan 2018

Keywords

  • Cr-EDTA
  • glomerular filtration rate
  • mannitol
  • plasma clearance
  • volume of distribution

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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