Vandermeulen Eva, De Sadeleer Carlos, Piepsz Amy, Ham Hamphrey R, Dobbeleir André A, Vermeire Simon T, Van Hoek Ingrid M, Daminet Sylvie, Slegers Guido, Peremans Kathelijne Y
Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
J Feline Med Surg. 2010 Aug;12(8):577-83. doi: 10.1016/j.jfms.2010.01.011. Epub 2010 May 8.
Estimation of the glomerular filtration rate (GFR) is a useful tool in the evaluation of kidney function in feline medicine. GFR can be determined by measuring the rate of tracer disappearance from the blood, and although these measurements are generally performed by multi-sampling techniques, simplified methods are more convenient in clinical practice. The optimal times for a simplified sampling strategy with two blood samples (2BS) for GFR measurement in cats using plasma (51)chromium ethylene diamine tetra-acetic acid ((51)Cr-EDTA) clearance were investigated. After intravenous administration of (51)Cr-EDTA, seven blood samples were obtained in 46 cats (19 euthyroid and 27 hyperthyroid cats, none with previously diagnosed chronic kidney disease (CKD)). The plasma clearance was then calculated from the seven point blood kinetics (7BS) and used for comparison to define the optimal sampling strategy by correlating different pairs of time points to the reference method. Mean GFR estimation for the reference method was 3.7+/-2.5 ml/min/kg (mean+/-standard deviation (SD)). Several pairs of sampling times were highly correlated with this reference method (r(2) > or = 0.980), with the best results when the first sample was taken 30 min after tracer injection and the second sample between 198 and 222 min after injection; or with the first sample at 36 min and the second at 234 or 240 min (r(2) for both combinations=0.984). Because of the similarity of GFR values obtained with the 2BS method in comparison to the values obtained with the 7BS reference method, the simplified method may offer an alternative for GFR estimation. Although a wide range of GFR values was found in the included group of cats, the applicability should be confirmed in cats suspected of renal disease and with confirmed CKD. Furthermore, although no indications of age-related effect were found in this study, a possible influence of age should be included in future studies.
肾小球滤过率（GFR）的评估是猫科医学中评估肾功能的一项有用工具。GFR可通过测量示踪剂从血液中消失的速率来确定，尽管这些测量通常通过多次采样技术进行，但简化方法在临床实践中更为方便。研究了使用血浆（51）铬乙二胺四乙酸（（51）Cr-EDTA）清除率，通过采集两份血样（2BS）进行GFR测量的简化采样策略的最佳时间。静脉注射（51）Cr-EDTA后，在46只猫（19只甲状腺功能正常和27只甲状腺功能亢进猫，均无先前诊断的慢性肾病（CKD））中采集了七份血样。然后根据七点血液动力学（7BS）计算血浆清除率，并通过将不同时间点对与参考方法相关联来用于比较，以确定最佳采样策略。参考方法的平均GFR估计值为3.7±2.5 ml/min/kg（平均值±标准差（SD））。几对采样时间与该参考方法高度相关（r（2）≥0.980），当第一个样本在示踪剂注射后30分钟采集，第二个样本在注射后198至222分钟之间采集时，结果最佳；或者第一个样本在36分钟采集，第二个样本在234或240分钟采集（两种组合的r（2）均为0.984）。由于与7BS参考方法相比，2BS方法获得的GFR值相似，因此简化方法可能为GFR估计提供一种替代方法。尽管在所纳入的猫组中发现了广泛的GFR值范围，但在怀疑患有肾病和确诊为CKD的猫中，其适用性仍需得到证实。此外，尽管本研究未发现年龄相关效应的迹象，但未来的研究应考虑年龄可能产生的影响。
