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125Iodine-iothalamate clearance in children. A simple method to measure glomerular filtration

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Abstract

Glomerular filtration rate (GFR) is the most widely used test to evaluate renal function. Several clearance markers have been used to measure GFR in adults. In children, however, a simple and reliable method to measure GFR is not available. Renal125iodine (I)-iothalamate clearance, after a single subcutaneous injection, is a simple and accurate test to measure GFR in adults. The validity of unlabelled iothalamate, as a marker for measurement of GFR in children, was reported recently. Unfortunately, the unlabelled iothalamate assay is arduous. We report our experience with a single subcutaneous injection of125I-iothalamate to measure GFR in normal children and those with renal disease. A weight-adjusted dosing regimen was adopted. This regimen resulted in sufficient above-background radioactivity in both blood and urine for reproducible measurement of GFR. Intra-test variability for GFR was not affected by the degree of renal insufficiency. The test was well tolerated with only 2 patients developing mild headache during the procedure. Our study showed that renal clearance of125I-iothalamate is reproducible, simple, and practical in healthy children and those with mild and advanced renal disease.

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References

  1. Baeur JH, Brooks CS, Burch RN (1982) Clinical appraisal of creatinine clearance as a measure of glomerular filtration. Am J Kidney Dis 2: 337–346

    Google Scholar 

  2. Walser M, Drew H H, La France DN (1988) Creatinine measurements often yield false estimates of progression in chronic renal failure. Kidney Int 34: 412–418

    Google Scholar 

  3. Levey AS (1989) Use of glomerular filtration rate to assess the progression of renal disease. Semin Nephrol 9: 370–379

    Google Scholar 

  4. Stake G, Monn E, Rootwelt K, Monclair T (1991) The clearance of iohexol as a measure of the filtration rate in children with chronic renal failure. Scand J Clin Lab Invest 51: 729–734

    Google Scholar 

  5. Russell CD, Bischoff PG, Kontzen FN, Rowell KL, Yester MV, Lloyd LK, Tauxe WN, Dubovsky EV (1985) Measurement of glomerular filtration rate: single injection plasma clearance method without urine collection. J Nucl Med 26: 1243–1247

    Google Scholar 

  6. Ham HR, Piepsz A (1991) Estimation of glomerular filtration rate in infants and in children using a single-plasma sample method. J Nucl Med 32: 1294–1297

    Google Scholar 

  7. Waller DG, Keast CM, Fleming JS, Ackery DM (1987) Measurement of glomerular filtration rate with technetium-99m DTPA: comparison of plasma clearance techniques. J Nucle Med 28: 372–377

    Google Scholar 

  8. Mulligan JS, Blue PW, Hasbargen JA (1990) Methods for measuring GFR with technetium-99m DTPA: an analysis of several common methods. J Nucl Med 31: 1211–1219

    Google Scholar 

  9. Israelit AH, Long DL, White MG, Hull A (1973) Measurement of glomerular filtration rate utilizing a single subcutaneous injection of I-iothalamate. Kidney Int 4: 346–349

    Google Scholar 

  10. Holliday MA, Heiborn D, Al-Uzri A, Uauy R, Conley S, Reisch J, Hogg RJ (1993) Serial measurements of GFR in infants using the continuous iothalamate infusion technique. Kidney Int 43: 1–6

    Google Scholar 

  11. Skinner R, Cole M, Pearson ADJ, Keir MJ, Price L, Wyllie RA, Coulthard MG, Craft AW (1994) Inaccuracy of glomerular filtration rate estimation from height/plasma creatinine ratio. Arch Dis Child 70: 387–390

    Google Scholar 

  12. Rolin HA III, Hall PM, Wei R (1984) Inaccuracy of estimated creatinine clearance for prediction of iothalamate glomerular filtration rate. Am J Kidney Dis 4: 48–54

    Google Scholar 

  13. Levey AS, Greene T, Schluchter MD, Cleary PA, Teschan PE, Lorenz RA, Molitch ME, Mitch WE, Seibert C, Hall PM, Steffes MW (1993) Glomerular filtration rate measurements in clinical trials. J Am Soc Nephrol 4: 1159–1171

    Google Scholar 

  14. Chandoke PS, Kogen BA, Al-daahwi A, Dobois J, Holliday MA (1990) Monitoring renal function in children with urological abnormalities. J Urol 144: 601–605

    Google Scholar 

  15. Handmaker H, Lowenstein JM (1975) Nuclear medicine in clinical pediatrics, appendix. Society of Nuclear Medicine. New York, p 270

    Google Scholar 

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Bajaj, G., Alexander, S.R., Browne, R. et al. 125Iodine-iothalamate clearance in children. A simple method to measure glomerular filtration. Pediatr Nephrol 10, 25–28 (1996). https://doi.org/10.1007/BF00863432

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  • DOI: https://doi.org/10.1007/BF00863432

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