Wang Bao-bao, Wu Yuan, Qin Yan, Gong Meng-chun, Shi Xi-min, Jing Hong-li, Li Fang, Chen Chao-ying, Song Hong-mei, Li Xue-mei
Department of Nephrology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Department of Nuclear Medicine, 4Department of Pediatrics, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2015 Apr;37(2):171-8. doi: 10.3881/j.issn.1000-503X.2015.02.007.
To evaluate the accuracy of plasma clearance of iohexol (PCio) for glomerular filtration rate (GFR) measurement in Chinese children with chronic kidney disease (CKD) and assess the feasibility of single-blood-sample method or dried capillary blood spots in determining the PCio.
Totally 45 CKD children were included,in whom the (99m) Technetium-diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) plasma clearance and iohexol plasma clearance were simultaneously determined. Blood samples were obtained 2,4,and 5 hours after injection. In addition, we also evaluated the efficacy of single blood sample method and dried blood spots method in iohexol plasma clearance.
Forty-five CKD children completed the iohexol plasma clearance and thirty-six children completed the (99m)Tc-DTPA plasma clearance at the same time among them. Thirteen children finished the iohexol dried blood spot clearance. The correlation coefficient between (99m)Tc-DTPA plasma clearance and iohexol plasma clearance was 0.941 and the bias was (6.53 ± 11.6) ml/ (min·1.73 m²), and the intraclass correlation coefficient (ICC) was high (ICC=0.947). The correlation between iohexol single-sample plasma clearance and double samples was also strong (r=0.958), with the bias being (4.26 ± 9.06)ml/(min·1.73 m²) and the ICC being 0.970. The iohexol clearance by dried blood spots showed a good correlation with the serum iohexol clearance (r=0.950), with the bias still being small [(0.48 ± 10.89)ml/(min·1.73 m²)].
Iohexol plasma clearance has satisfactory agreement with (99m)Tc-DTPA plasma clearance and can be used as an ideal method to measure GFR in CKD children. The single-sample method and dried blood spots method make iohexol plasma clearance more convenient and practical.
评估碘海醇血浆清除率（PCio）用于测量中国慢性肾脏病（CKD）儿童肾小球滤过率（GFR）的准确性，并评估单血样法或干血斑法测定PCio的可行性。
纳入45例CKD儿童，同时测定其锝（99m）-二乙三胺五乙酸（（99m）Tc-DTPA）血浆清除率和碘海醇血浆清除率。注射后2、4和5小时采集血样。此外，我们还评估了单血样法和干血斑法在碘海醇血浆清除率测定中的效果。
45例CKD儿童完成了碘海醇血浆清除率测定，其中36例儿童同时完成了（99m）Tc-DTPA血浆清除率测定。13例儿童完成了碘海醇干血斑清除率测定。（99m）Tc-DTPA血浆清除率与碘海醇血浆清除率的相关系数为0.941，偏差为（6.53±11.6）ml/（min·1.73 m²），组内相关系数（ICC）较高（ICC=0.947）。碘海醇单样本血浆清除率与双样本之间的相关性也很强（r=0.958），偏差为（4.26±9.06）ml/（min·1.73 m²），ICC为0.970。干血斑法测定的碘海醇清除率与血清碘海醇清除率显示出良好的相关性（r=0.950），偏差仍然较小[（0.48±10.89）ml/（min·1.73 m²）]。
碘海醇血浆清除率与（99m）Tc-DTPA血浆清除率具有良好的一致性，可作为测量CKD儿童GFR的理想方法。单血样法和干血斑法使碘海醇血浆清除率测定更方便实用。
