Isaka Y, Yamamoto S, Fujiwara Y, Shin S H, Ochi S, Kamada T, Ueda N
1st Department of Medicine, Osaka University Medical School.
Rinsho Byori. 1992 Jul;40(7):703-7.
Glomerular filtration rate (GFR) is believed to be the overall index of renal function, and the renal clearance of inulin (Cin) obtained during constant intravenous infusion has long been accepted as the gold standard of GFR measurement. Because of a number of technical difficulties inherent in the assay of inulin concentration in urine and plasma, its utility in clinical practice is limited. Iothalamate, urographic contrast medium, which behaves and is excreted in a fashion similar to inulin, has been accepted as a good filtration marker. We examined whether GFR could be estimated by ionic contrast media, "iothalamate" and non-ionic contrast media, "iohexol", when the high-performance liquid chromatography (HPLC) system was used as the analytic method. In our HPLC system, iothalamate and iohexol could be simultaneously determined. The assay results gave linearity within the wide range of concentrations tested. In seventeen subjects, the renal clearances of creatinine, iothalamate, and iohexol (Ccr, Ciot, and Cioh) were compared with that of inulin. The slopes with zero intercept of Ccr vs Cin, Ciot vs Cin, and Cioh vs Cin were 1.24 +/- 0.02, 1.06 +/- 0.02, and 0.83 +/- 0.02, respectively. In conclusion, an excellent correlation of renal clearance of iothalamate with that of inulin was obtained in patients with a wide range of renal function and normal volunteers. This justifies the use of the single injection of iothalamate and HPLC system as the analytic method in the measurement of GFR.
肾小球滤过率(GFR)被认为是肾功能的总体指标,在持续静脉输注过程中获得的菊粉肾清除率(Cin)长期以来一直被公认为GFR测量的金标准。由于尿液和血浆中菊粉浓度测定存在一些固有的技术难题,其在临床实践中的应用受到限制。碘他拉酸盐,一种尿路造影剂,其行为和排泄方式与菊粉相似,已被公认为一种良好的滤过标志物。我们研究了在使用高效液相色谱(HPLC)系统作为分析方法时,离子型造影剂“碘他拉酸盐”和非离子型造影剂“碘海醇”是否可用于估算GFR。在我们的HPLC系统中,可以同时测定碘他拉酸盐和碘海醇。测定结果在测试的宽浓度范围内呈线性。在17名受试者中,比较了肌酐、碘他拉酸盐和碘海醇的肾清除率(Ccr、Ciot和Cioh)与菊粉的肾清除率。Ccr与Cin、Ciot与Cin、Cioh与Cin的零截距斜率分别为1.24±0.02、1.06±0.02和0.83±0.02。总之,在肾功能范围广泛的患者和正常志愿者中,碘他拉酸盐的肾清除率与菊粉的肾清除率具有良好的相关性。这证明了单次注射碘他拉酸盐并使用HPLC系统作为分析方法来测量GFR的合理性。