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Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures

BACKGROUND: Glomerular filtration rate (GFR) increases after a heavy protein load; an increase termed renal functional response (RFR). Decreased RFR could be a marker of early kidney damage, but published methods are cumbersome in the outpatient setting. The present study investigates the use of ioh...

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Autores principales: Lillås, Bjørn Steinar, Tøndel, Camilla, Gjerde, Anna, Vikse, Bjørn Egil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857819/
https://www.ncbi.nlm.nih.gov/pubmed/33564417
http://dx.doi.org/10.1093/ckj/sfz167
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author Lillås, Bjørn Steinar
Tøndel, Camilla
Gjerde, Anna
Vikse, Bjørn Egil
author_facet Lillås, Bjørn Steinar
Tøndel, Camilla
Gjerde, Anna
Vikse, Bjørn Egil
author_sort Lillås, Bjørn Steinar
collection PubMed
description BACKGROUND: Glomerular filtration rate (GFR) increases after a heavy protein load; an increase termed renal functional response (RFR). Decreased RFR could be a marker of early kidney damage, but published methods are cumbersome in the outpatient setting. The present study investigates the use of iohexol clearance to measure RFR in outpatients using both one- and two-sample methods. METHODS: Fourteen healthy volunteers with a mean ± SD age of 42 ± 12 years were included (six males and eight females). GFR was measured using plasma iohexol clearance with one- and two-sample methodologies. Four measurements in each individual were performed: one baseline test and three protein loading tests containing 80 g protein (commercially available protein supplementations from Myo Nutrition and Proteinfabrikken and 350 g chicken breast). RFR was calculated as percentage increase in GFR from the baseline test. RESULTS: Mean RFR was 11.4 ± 5.4% and 12.1 ± 6.4% using one- and two-sample methods, respectively. The three different protein loads resulted in similar mean RFR but there was considerable intra-individual variability. One- and two-sample methods for measurement of RFR showed similar results with near-identical means, but there was some intra-individual variation that was similar for different protein loads. The overall 95% limit of agreement between one- and two-sample methods for calculating RFR was −8.7 to 7.3. CONCLUSIONS: RFR can be investigated using plasma iohexol clearance in an outpatient setting. Protocols using commercially available protein supplementation showed a mean RFR of about 12%. One- and two-sample methods for measuring RFR yield similar results.
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spelling pubmed-78578192021-02-08 Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures Lillås, Bjørn Steinar Tøndel, Camilla Gjerde, Anna Vikse, Bjørn Egil Clin Kidney J Original Articles BACKGROUND: Glomerular filtration rate (GFR) increases after a heavy protein load; an increase termed renal functional response (RFR). Decreased RFR could be a marker of early kidney damage, but published methods are cumbersome in the outpatient setting. The present study investigates the use of iohexol clearance to measure RFR in outpatients using both one- and two-sample methods. METHODS: Fourteen healthy volunteers with a mean ± SD age of 42 ± 12 years were included (six males and eight females). GFR was measured using plasma iohexol clearance with one- and two-sample methodologies. Four measurements in each individual were performed: one baseline test and three protein loading tests containing 80 g protein (commercially available protein supplementations from Myo Nutrition and Proteinfabrikken and 350 g chicken breast). RFR was calculated as percentage increase in GFR from the baseline test. RESULTS: Mean RFR was 11.4 ± 5.4% and 12.1 ± 6.4% using one- and two-sample methods, respectively. The three different protein loads resulted in similar mean RFR but there was considerable intra-individual variability. One- and two-sample methods for measurement of RFR showed similar results with near-identical means, but there was some intra-individual variation that was similar for different protein loads. The overall 95% limit of agreement between one- and two-sample methods for calculating RFR was −8.7 to 7.3. CONCLUSIONS: RFR can be investigated using plasma iohexol clearance in an outpatient setting. Protocols using commercially available protein supplementation showed a mean RFR of about 12%. One- and two-sample methods for measuring RFR yield similar results. Oxford University Press 2019-11-26 /pmc/articles/PMC7857819/ /pubmed/33564417 http://dx.doi.org/10.1093/ckj/sfz167 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Articles
Lillås, Bjørn Steinar
Tøndel, Camilla
Gjerde, Anna
Vikse, Bjørn Egil
Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures
title Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures
title_full Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures
title_fullStr Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures
title_full_unstemmed Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures
title_short Measurement of renal functional response using iohexol clearance—a study of different outpatient procedures
title_sort measurement of renal functional response using iohexol clearance—a study of different outpatient procedures
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857819/
https://www.ncbi.nlm.nih.gov/pubmed/33564417
http://dx.doi.org/10.1093/ckj/sfz167
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