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

Katalin Kiss, M. Molnár, Sören Söndergaard, Gyula Molnár, Sven Erik Ricksten

Research output: Contribution to journalArticle

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 -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
JournalClinical Physiology and Functional Imaging
DOIs
Publication statusAccepted/In press - 2016

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Mannitol
Glomerular Filtration Rate
Edetic Acid
Injections
Serum
Creatinine
Outpatients
Body Weight
Kidney

Keywords

  • Cr-EDTA
  • Glomerular filtration rate
  • Mannitol
  • Plasma clearance
  • Volume of distribution

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Mannitol clearance for the determination of glomerular filtration rate-a validation against clearance of 51Cr-EDTA. / Kiss, Katalin; Molnár, M.; Söndergaard, Sören; Molnár, Gyula; Ricksten, Sven Erik.

In: Clinical Physiology and Functional Imaging, 2016.

Research output: Contribution to journalArticle

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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 -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 Br{\o}chner-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.",
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AB - 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 -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.

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KW - Volume of distribution

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