CHRU de Tours, Laboratoire de Biochimie et Biologie Moléculaire, Tours, France.
J Clin Lab Anal. 2012 Sep;26(5):376-83. doi: 10.1002/jcla.21537.
Estimated glomerular filtration rate (eGFR) methods are not sufficiently reliable in renal transplant recipients (RTR) and should be replaced by iohexol plasma clearance measurement. However, this method has poor availability in health centers. The aim of our study was to develop a high-performance liquid chromatography (HPLC) method for plasma iohexol measurement in routine practice and to evaluate its plasma clearance as a reference of GFR. We developed an HPLC method using UV detection. We evaluated sample storage conditions to provide recommendations for routine practice. Then, we compared GFRbased on plasma iohexol clearance (GFR-iohexol) to eGFR using modification of diet in renal disease, Cockcroft and Gault, and CDK-EPIequations in 40 RTR. The method was validated over a concentration range of 15-300 μg/l. Excellent linearity (r > 0.998), inter- and intraday precision (CV < 3.3%), and accuracy (>96.8%) were complied with ICH guidelines. We also demonstrated excellent samples stability (9 days). Although eGFR methods are not references in RTR, we found a correct concordance between eGFR and GFR-iohexol in our population. To conclude, our method is simple, rapid, accurate, and reliable for routine clinical and research use especially in RTR.
估算肾小球滤过率 (eGFR) 方法在肾移植受者 (RTR) 中不够可靠,应该用碘海醇血浆清除率测量来替代。然而,这种方法在卫生中心的可用性较差。我们的研究目的是开发一种在常规实践中测量血浆碘海醇的高效液相色谱 (HPLC) 方法,并评估其血浆清除率作为 GFR 的参考。我们开发了一种使用紫外检测的 HPLC 方法。我们评估了样本储存条件,为常规实践提供了建议。然后,我们在 40 名 RTR 中比较了基于血浆碘海醇清除率的 GFR (GFR-iohexol) 与 eGFR 使用肾脏病饮食改良、Cockcroft 和 Gault 以及 CDK-EPI 方程。该方法在 15-300μg/l 的浓度范围内进行了验证。符合 ICH 指南的优异线性 (r>0.998)、日内和日间精密度 (CV<3.3%) 和准确性 (>96.8%)。我们还证明了样品具有出色的稳定性 (9 天)。尽管 eGFR 方法在 RTR 中不是参考值,但我们发现我们的人群中 eGFR 与 GFR-iohexol 之间存在正确的一致性。总之,我们的方法简单、快速、准确、可靠,特别适用于 RTR 的常规临床和研究用途。