作者
Natalie Ebert,Elke Schaeffner,Jesse C. Seegmiller,Marco van Londen,Arend Bökenkamp,Étienne Cavalier,Pierre Delanaye,Laurence Derain‐Dubourg,Bjørn O. Eriksen,Olafur S. Indridason,Runólfur Pálsson,Tariq Shafi,Anders Christensson,Sebastjan Bevc,Fabiola Carrara,Marie Courbebaisse,R. Neil Dalton,Markus van der Giet,Toralf Melsom,Shona Methven,Gunnar Nordin,Hans Pottel,Andrew D. Rule,Matias Trillini,Christine A. White
摘要
International consensus supports the development of standardized protocols for measured glomerular filtration rate (mGFR) to facilitate the integration of mGFR testing in both clinical and research settings. To this end, the European Kidney Function Consortium convened an international group of experts with relevant experience in mGFR. The working group performed an extensive literature search to inform the development of recommendations for mGFR determination using 1-compartment plasma clearance models and iohexol as the exogenous filtration marker. Iohexol was selected as it is non-radio labeled, inexpensive, and safe, can be assayed at a central laboratory, and the other commonly used non-radio-labeled tracers have been (inulin) or are soon to be (iothalamate) discontinued. A plasma clearance model was selected over urine clearance as it requires no urine collection. A 1 compartment was preferred to 2 compartments as it requires fewer samples. The recommendations are based on published evidence complemented by expert opinion. The consensus paper covers practical advice for patients and health professionals, preparation, administration, and safety aspects of iohexol, laboratory analysis, blood sample collection and sampling times using both multiple and single-sample protocols, description of the mGFR mathematical calculations, as well as implementation strategies. Supplementary materials include patient and provider information sheets, standard operating procedures, a study protocol template, and support for mGFR calculation.