Open AccessMeasurement of glomerular filtration rate using a reference method
Author(s) -
Laurence Chardon,
Laurence Dubourg,
Chantal BarinLe Guellec,
Francis Guinard,
Thierry Hannedouche,
JeanMichel Halimi,
Christophe Mariat
Publication year - 2019
Publication title -
annales de biologie clinique
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.167
H-Index - 27
eISSN - 1950-6112
pISSN - 0003-3898
DOI - 10.1684/abc.2019.1455
Subject(s) - renal function , urology , medicine , creatinine , iohexol , kidney transplantation , gold standard (test) , urinary system , kidney , intensive care medicine
Direct measurement methods of glomerular filtration rate (GFR) are considered as the gold standard to assess kidney function. Following the withdrawal of the Proinuline Serb® specialty by the French National Health Surveillance Agency, iohexol remains the most suitable marker to replace inulin as the marker for GFR in France. The assay is performed by high performance liquid chromatography (HPLC) coupled with ultraviolet (UV) detection or by mass spectrometry. Plasma clearance measurement is the protocol of choice: single-sample protocols dominate, but multiple-sample protocols may be more accurate in specific situations to improve accuracy. In some cases, urinary clearance protocols may be proposed. National and international recommendations suggest using a GFR measurement as a confirmatory test in cases where the creatinine-based estimated GFR is inappropriate, ie clinical situations characterized by a significant alteration of muscle mass or volume distribution. The indications retained by the working group were graded according to the level of recommendations. The essential indications are the evaluation of living kidney donor, the monitoring of kidney allograft function at one year post-transplantation, drugs with narrow therapeutic range (anticoagulant, chemotherapy) in patients with inadequate estimation of GFR by creatinine and clinical research.