van Gelder Maaike K, Stevens Jasper, Pieters Tobias T, Vaessen Koen R D, Joles Jaap A, Verhaar Marianne C, Gerritsen Karin G F
Department of Nephrology and Hypertension, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Biology (Basel). 2021 May 23;10(6):461. doi: 10.3390/biology10060461.
The preclinical evaluation of novel therapies for chronic kidney disease requires a simple method for the assessment of kidney function in a uremic large animal model. An intravenous bolus of iohexol was administered to goats (13 measurements in = 3 goats) and pigs (23 measurements in = 5 pigs) before and after induction of kidney failure, followed by frequent blood sampling up to 1440 min. Plasma clearance (CL) was estimated by a nonlinear mixed-effects model (CL) and by a one-compartmental pharmacokinetic disposition model using iohexol plasma concentrations during the terminal elimination phase (CL). A simple method (CL) for the calculation of plasma clearance was developed based on the most appropriate relationship between CL and CL. CL and CL showed good agreement (CL/CL ratio: 1.00 ± 0.07; bias: 0.03 ± 1.64 mL/min; precision CL and CL: 80.9% and 80.7%, respectively; the percentage of CL estimates falling within ±30% (P30) or ±10% (P10) of CL: 53% and 12%, respectively). For mGFR vs. mGFR, bias was -0.25 ± 2.24 and precision was 49.2% and 53.6%, respectively, P30 and P10 for mGFR based on CL were 71% and 24%, respectively. A simple method for measurement of GFR in healthy and uremic goats and pigs was successfully developed, which eliminates the need for continuous infusion of an exogenous marker, urine collection and frequent blood sampling.
慢性肾病新疗法的临床前评估需要一种简单的方法来评估尿毒症大动物模型的肾功能。在诱导肾衰竭前后,对山羊(n = 3只山羊,13次测量)和猪(n = 5头猪,23次测量)静脉推注碘海醇,随后频繁采血直至1440分钟。通过非线性混合效应模型(CL)和使用终末消除期碘海醇血浆浓度的单室药代动力学处置模型(CL)估算血浆清除率(CL)。基于CL与CL之间最合适的关系,开发了一种计算血浆清除率的简单方法(CL)。CL与CL显示出良好的一致性(CL/CL比值:1.00±0.07;偏差:0.03±1.64 mL/min;CL和CL的精密度分别为80.9%和80.7%;CL估计值落在CL的±30%(P30)或±10%(P10)范围内的百分比分别为53%和12%)。对于mGFR与mGFR,偏差为-0.25±2.24,精密度分别为49.2%和53.6%,基于CL的mGFR的P30和P10分别为71%和24%。成功开发了一种在健康和尿毒症山羊及猪中测量GFR的简单方法,该方法无需持续输注外源性标志物、收集尿液和频繁采血。