In:
Clinical Physiology and Functional Imaging, Wiley, Vol. 37, No. 6 ( 2017-11), p. 588-595
Kurzfassung:
In patients with fluid retention, the plasma clearance of 51 Cr‐ EDTA (Cl exp obtained by multiexponential fit) may overestimate the glomerular filtration rate ( GFR ). The present study was undertaken to compare a gamma‐variate plasma clearance (Cl gv) with the urinary plasma clearance of 51 Cr‐ EDTA (Cl u ) in patients with cirrhosis with and without fluid retention. A total of 81 patients with cirrhosis (22 without fluid retention, 59 with ascites) received a quantitative intravenous injection of 51 Cr‐ EDTA followed by plasma and quantitative urinary samples for 5 h. Cl gv was determined from the injected dose relative to the plasma concentration‐time area, obtained by a gamma‐variate iterative fit. Cl exp and Cl u were determined by standard technique. In patients without fluid retention, Cl gv , Cl exp and Cl u were closely similar. The difference between Cl gv and Cl u (Cl gv – Cl u = ΔCl) was mean −0·6 ml min −1 1·73 m −2 . In patients with ascites, ΔCl was significantly higher (11·8 ml min −1 1·73 m −2 , P 〈 0·0001), but this value was lower than Cl exp – Cl u (17·5 mL min −1 1·73 m −2 , P 〈 0·01). ΔCl increased with lower values of GFR ( P 〈 0·001). In conclusion, in patients with fluid retention and ascites Cl gv and Cl exp overestimates GFR substantially, but the overestimation is smaller with Cl gv . Although Cl u may underestimate GFR slightly, patients with ascites should collect urine quantitatively to obtain a reliable measurement of GFR .
Materialart:
Online-Ressource
ISSN:
1475-0961
,
1475-097X
DOI:
10.1111/cpf.2017.37.issue-6
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2017
ZDB Id:
2004626-1
