scholarly journals Iothalamate Clearance Adjusted for BSA

2020 ◽  
Author(s):  
Keyword(s):  
Iothalamate Clearance

scholarly journals Slope of serial glomerular filtration rate and the progression of diabetic glomerular disease.

1993 ◽  
Vol 3 (7) ◽  
pp. 1358-1370
Author(s):  
S M Austin ◽  
J S Lieberman ◽  
L D Newton ◽  
M Mejia ◽  
W A Peters ◽  
...  
Keyword(s):  
Filtration Rate ◽  
Glomerular Disease ◽  
Pore Density ◽  
Glomerular Function ◽  
Group 2 ◽  
Global Glomerulosclerosis ◽  
Iothalamate Clearance ◽  
Nephrotic Range Proteinuria ◽  
Uniform Reduction ◽  
Group 1

Glomerular function was evaluated longitudinally over a 24- to 48-month period in 18 patients with diabetic glomerular disease (DGD) manifested by proteinuria. GFR was determined by iothalamate clearance at 4-month intervals. The patients were divided into two groups: Group 1 (N = 9) had subnephrotic proteinuria and an initially normal GFR of 91 +/- 8 mL/min. Group 2 (N = 9) had nephrotic-range proteinuria, and initial GFR was reduced to 53 +/- 5 mL/min. Serial GFR fluctuated over time in Group 1, but no trend towards hypofiltration was evident. In contrast, GFR declined linearly in Group 2 at 1.1 +/- 0.3 mL/min per month. The transglomerular sieving of uncharged dextrans of graded size was analyzed and initially revealed a uniform reduction in glomerular pore density and an enhancement of shuntlike pores. Pore density was initially reduced by 80% and declined further after 24 months in nephrotic Group 2; corresponding pore density in subnephrotic Group 1 was reduced by half but remained constant. Renal biopsy of four members of Group 1 revealed a 22% prevalence of global glomerulosclerosis. Remaining open glomeruli exhibited hypertrophy, excessive extracellular matrix, and deformation of epithelial podocytes. The latter abnormality appeared to be the predominant determinant of lowered ultrafiltration capacity. It was inferred that trials of therapy to attenuate the progression of DGD should be initiated at a functional level similar to that in subnephrotic Group 1. Because GFR is unlikely to decline over a 2- to 4-yr period, it is suggested that such trials be extended for longer periods. Alternatively, morphometric analysis of serial renal biopsies may shorten the time needed to demonstrate effective renoprotection in DGD.

scholarly journals Early Glomerular Hyperfiltration and Long-Term Kidney Outcomes in Type 1 Diabetes

2019 ◽  
Vol 14 (6) ◽  
pp. 854-861 ◽  
Author(s):  
Mark E. Molitch ◽  
Xiaoyu Gao ◽  
Ionut Bebu ◽  
Ian H. de Boer ◽  
John Lachin ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Confidence Interval ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Glomerular Hyperfiltration ◽  
Iothalamate Clearance ◽  
Subsequent Risk

Background and objectivesGlomerular hyperfiltration has been considered to be a contributing factor to the development of diabetic kidney disease (DKD). To address this issue, we analyzed GFR follow-up data on participants with type 1 diabetes undergoing 125I-iothalamate clearance on entry into the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications study.Design, setting, participants, & measurementsThis was a cohort study of DCCT participants with type 1 diabetes who underwent an 125I-iothalamate clearance (iGFR) at DCCT baseline. Presence of hyperfiltration was defined as iGFR levels ≥140 ml/min per 1.73 m2, with secondary thresholds of 130 or 150 ml/min per 1.73 m2. Cox proportional hazards models assessed the association between the baseline hyperfiltration status and the subsequent risk of reaching an eGFR <60 ml/min per 1.73 m2.ResultsOf the 446 participants, 106 (24%) had hyperfiltration (iGFR levels ≥140 ml/min per 1.73 m2) at baseline. Over a median follow-up of 28 (interquartile range, 23, 33) years, 53 developed an eGFR <60 ml/min per 1.73 m2. The cumulative incidence of eGFR <60 ml/min per 1.73 m2 at 28 years of follow-up was 11.0% among participants with hyperfiltration at baseline, compared with 12.8% among participants with baseline GFR <140 ml/min per 1.73 m2. Hyperfiltration was not significantly associated with subsequent risk of developing an eGFR <60 ml/min per 1.73 m2 in an unadjusted Cox proportional hazards model (hazard ratio, 0.83; 95% confidence interval, 0.43 to 1.62) nor in an adjusted model (hazard ratio, 0.77; 95% confidence interval, 0.38 to 1.54). Application of alternate thresholds to define hyperfiltration (130 or 150 ml/min per 1.73 m2) showed similar findings.ConclusionsEarly hyperfiltration in patients with type 1 diabetes was not associated with a higher long-term risk of decreased GFR. Although glomerular hypertension may be a mechanism of kidney injury in DKD, higher total GFR does not appear to be a risk factor for advanced DKD.

scholarly journals The Iothalamate Clearance in Cats with Experimentally Induced Renal Failure.

1996 ◽  
Vol 58 (8) ◽  
pp. 803-804 ◽  
Author(s):  
Fumihito OHASHI ◽  
Kazuo KURODA ◽  
Terumasa SHIMADA ◽  
Yasuaki SHIMADA ◽  
Mituaki OTA
Keyword(s):  
Renal Failure ◽  
Iothalamate Clearance ◽  
Experimentally Induced

scholarly journals The Impact of Different Induction Immunosuppressive Therapy on Long-Term Kidney Transplant Function When Measured by Iothalamate Clearance

2020 ◽  
Vol 12 (12) ◽  
pp. 787-793
Author(s):  
Tambi Jarmi ◽  
Samir Khouzam ◽  
Nitika Shekhar ◽  
Meray Hosni ◽  
Launia White ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Transplant Function ◽  
The Impact ◽  
Iothalamate Clearance

Renal Handling of Creatinine in Nephrotic and Non-Nephrotic Patients

1970 ◽  
Vol 38 (5) ◽  
pp. 555-562 ◽  
Author(s):  
C. F. Anderson ◽  
D. M. Jaecks ◽  
H. S. Ballon ◽  
J. R. De Palma ◽  
R. E. Cutler
Keyword(s):  
Renal Function ◽  
Normal Subjects ◽  
Tubular Secretion ◽  
Inulin Clearance ◽  
Clearance Ratio ◽  
Renal Handling ◽  
Secretory Rate ◽  
Ureteral Catheterization ◽  
Iothalamate Clearance

1. The endogenous creatinine/GFR (inulin or free [57Co]cyanocobalamin or [125I]iothalamate) clearance ratios were determined in ninety-nine non-nephrotic patients and subjects and in sixteen nephrotic patients. The clearance ratios of the nephrotic patients were not significantly different from those of the non-nephrotic patients and normal subjects. 2. The clearance ratios increased as the GFR fell from 176 to below 15 ml/min, then decreased toward unity at lower GFR values. 3. In an attempt to explain this biphasic relationship, two further studies were performed. Endogenous creatinine/inulin and [14C]creatinine/inulin clearance ratios were simultaneously determined in seventeen additional patients. The [14C]creatinine/inulin clearance ratio was the larger of the two in all patients with a GFR greater than 15 ml/min. In another group of eight patients with unequal-sized kidneys, who were studied during bilateral ureteral catheterization, the endogenous creatinine/inulin clearance ratios were determined and found not to differ significantly. 4. The three studies suggest that there is significant tubular secretion of creatinine at all levels of renal function. The increasing clearance ratio of endogenous creatinine/GFR as the GFR decreases is not due to increased tubular secretion of creatinine nor a result of a difference in creatinine handling by diseased kidneys, but rather a reflection of the decreasing fraction of non-creatinine chromogen to the total creatinine chromogen. The smaller clearance ratio at a very low GFR would be expected if the maximal tubular secretory rate of creatinine was exceeded.

scholarly journals Overweight young female kidney donors have low renal functional reserve postdonation

2018 ◽  
Vol 315 (3) ◽  
pp. F454-F459 ◽  
Author(s):  
Marco van Londen ◽  
Anouk W. M. A. Schaeffers ◽  
Martin H. de Borst ◽  
Jaap A. Joles ◽  
Gerjan Navis ◽  
...  
Keyword(s):  
Young Female ◽  
Kidney Donation ◽  
Functional Reserve ◽  
Kidney Donors ◽  
Renal Functional Reserve ◽  
Increased Risk ◽  
Before And After ◽  
End Stage ◽  
The Relationship ◽  
Iothalamate Clearance

Maintenance of adequate renal function after living kidney donation is important for donor outcome. Overweight donors, in particular, may have an increased risk for end-stage kidney disease (ESKD), and young female donors have an increased preeclampsia risk. Both of these risks may be associated with low postdonation renal functional reserve (RFR). Because we previously found that higher body mass index (BMI) was associated with lower postdonation RFR, we now studied the relationship between BMI and RFR in young female donors. RFR, the rise in glomerular filtration rate (GFR) (125I-iothalamate clearance) during dopamine, was measured in female donors (<45 yr) before and after kidney donation. Donors who are overweight (BMI >25) and nonoverweight donors were compared by Studentʼs t-test; the association was subsequently explored with regression analysis. We included 105 female donors [age 41 (36–44) median(IQR)] with a BMI of 25 (22–27) kg/m2. Predonation GFR was 118 (17) ml/min [mean(SD)] rising to 128 (19) ml/min during dopamine; mean RFR was 10 (10) ml/min. Postdonation GFR was 76 (13) ml/min, rising to 80 (12); RFR was 4 (6) ml/min ( P < 0.001 vs. predonation). In overweight donors, RFR was fully lost after donation (1 ml/min vs. 10 ml/min predonation, P < 0.001), and BMI was inversely associated with RFR after donation, independent of confounders (standardized β 0.37, P = 0.02). Reduced RFR might associate with the risk of preeclampsia and ESKD in kidney donors. Prospective studies should explore whether RFR is related to preeclampsia and whether BMI reduction before conception is of benefit to overweight female kidney donors during and after pregnancy.

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