Glomerular Filtration Rate Measured Based on Iomeprol Clearance Assessed at CT Urography in Living Kidney Donor Candidates

被引:2
|
作者
Stehle, Thomas [1 ,2 ,3 ]
Wei, Felix [1 ,4 ]
Brabant, Severine [9 ]
Luciani, Alain [1 ,4 ]
Grimbert, Philippe [2 ,3 ]
Prie, Dominique [9 ,10 ]
Reizine, Edouard [1 ,4 ]
Durrbach, Antoine [2 ,3 ,11 ,12 ]
Mule, Sebastien [1 ,4 ]
Hulin, Anne [1 ,5 ]
Boueilh, Anna [1 ,2 ,3 ]
Blain, Maxime [1 ,2 ,4 ]
Champy, Cecile-Maud [1 ,6 ]
Ingels, Alexandre [1 ,6 ]
Matignon, Marie [1 ,3 ]
Brasseur, Paul [1 ,7 ,8 ]
Canoui-Poitrine, Florence [1 ,7 ,8 ]
Pigneur, Frederic [1 ,4 ]
机构
[1] Univ Paris Est Creteil, Inst Natl Sante & Rech Med INSERM U955, Inst Mondor Rech Biomed, Creteil, France
[2] Hop Univ Henri Mondor, AP HP, Serv Nephrol & Transplantat, Creteil, France
[3] Hop Univ Henri Mondor, AP HP, Federat Hosp Univ Innovat Therapy Immune Disorders, Creteil, France
[4] Hop Univ Henri Mondor, AP HP, Serv Imagerie Med, Creteil, France
[5] Hop Univ Henri Mondor, AP HP, Lab Pharmacol, Creteil, France
[6] Hop Univ Henri Mondor, AP HP, Serv Urol, Creteil, France
[7] Hop Univ Henri Mondor, AP HP, Serv Sante Publ, Creteil, France
[8] Hop Univ Henri Mondor, AP HP, Unite Rech Clin, Creteil, France
[9] Grp Hosp Necker Enfants Malad, AP HP, Serv Physiol & Explorat Fonct, Paris, France
[10] Univ Paris Cite, Fac Med, INSERM U1151, Paris, France
[11] Univ Paris Saclay, Fac Med, Orsay, France
[12] Inst Gustave Roussy, INSERM, UMR 1186, Villejuif, France
关键词
CREATININE CLEARANCE; SERUM CREATININE; PLASMA SAMPLE; GATES METHOD; EQUATION; PHARMACOKINETICS; VALIDATION; GFR;
D O I
10.1148/radiol.230567
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Background: Estimating glomerular filtration rate (GFR) from serum creatinine can be inaccurate, and current procedures for measuring GFR are time-consuming and cumbersome. Purpose: To develop a method for measuring GFR based on iomeprol clearance assessed at CT urography in kidney donor candidates and compare this with iohexol clearance (reference standard for measuring GFR). Materials and Methods: This cross-sectional retrospective study included data from kidney donor candidates who underwent both iohexol clearance and CT urography between July 2016 and October 2022. CT -measured GFR was calculated as the iomeprol excretion rate in the urinary system between arterial and excretory phases (Hounsfield units times milliliters per minute) divided by a surrogate for serum iomeprol concentration in the aorta at the midpoint (in Hounsfield units). Performance of CT -measured GFR was assessed with use of mean bias (mean difference between CT -measured GFR and iohexol clearance), precision (the distance between quartile 1 and quartile 3 of the bias [quartile 3 minus quartile 1], with a small value indicating high precision), and accuracy (percentage of CT -measured GFR values falling within 10%, 20%, and 30% of iohexol clearance values). Intraobserver agreement was assessed for 30 randomly selected individuals with the Lin concordance correlation coefficient. Results: A total of 75 kidney donor candidates were included (mean age, 51 years +/- 13 [SD]; 45 female). The CT -measured GFR was unbiased (1.1 mL/min/1.73 m2 [95% CI: -1.9, 4.1]) and highly precise (16.2 mL/min/1.73 m2 [quartiles 1 to 3, -6.6 to 9.6]). The accuracy of CT -measured GFR within 10%, 20%, and 30% was 61.3% (95% CI: 50.3, 72.4), 88.0% (95% CI: 80.7, 95.4), and 100%, respectively. Concordance between CT -based GFR measurements taken 2 months apart was almost perfect (correlation coefficient, 0.99 [95% CI: 0.98, 0.99]). Conclusion: In living kidney donors, GFR measured based on iomeprol clearance assessed at CT urography showed good agreement with GFR measured based on iohexol clearance. (c) RSNA, 2023
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页数:9
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