Abstract
Abstract
Background
The 2018 BNMS Glomerular Filtration Rate (GFR) guidelines recommend a single-sample technique with the sampling time dictated by the expected renal function, but this is not known with any accuracy before the test. We aimed to assess whether the sampling regime suggested in the guidelines is optimal and determine the error in GFR result if the sample time is chosen incorrectly. We can then infer the degree of flexibility in the sampling regime.
Methods
Data from 6328 patients referred for GFR assessment at 6 different hospitals for a variety of indications were reviewed. The difference between the single-sample (Fleming) GFR result at each sample time and the slope–intercept GFR result at each hospital was calculated. A second dataset of 777 studies from one hospital with nine samples collected from 5 min to 8 h post-injection was analysed to provide a reference GFR to which the single-sample results were compared.
Results
Recommended single-sample times have been revised: for an expected GFR above 90 ml/min/1.73m2 a 2-h sample is recommended; between 50 and 90 ml/min/1.73m2 a 3-h sample is recommended; and between 30 and 50 ml/min/1.73m2 a 4-h sample is recommended. Root mean square error in single-sample GFR result compared with slope–intercept can be kept less than or equal to 3.30 ml/min/1.73m2 by following these recommendations.
Conclusion
The results of this multisite study demonstrate a reassuringly wide range of sample times for an acceptably accurate single-sample GFR result. Modified recommended single-sample times have been proposed in line with the results, and a lookup table has been produced of rms errors across the full range of GFR results for the three sample times which can be used for error reporting of a mistimed sample.
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging,Instrumentation,Biomedical Engineering,Radiation
Reference13 articles.
1. Burniston M et al. Clinical guideline for the measurement of glomerular filtration rate (GFR) using plasma sampling. Report 2018 replaces 2004 guideline. https://cdn.ymaws.com/www.bnms.org.uk/resource/resmgr/guidelines/bnms_gfr_guidelines_in_bnms_.pdf. Accessed 22 Feb 2021.
2. Fleming JS, Zivanovic MA, Blake GM, Burniston M, Cosgriff PS, British Nuclear Medicine Society. Guidelines for the measurement of glomerular filtration rate using plasma sampling. Nucl Med Commun. 2004;25:759–69.
3. Murray AW, Lawson RS, Cade SC, Hall DO, Kenny B, O’Shaughnessy E, Taylor J, Towey D, White D, Carson K, Institute of Physics and Engineering in Medicine, Nuclear Medicine Software Quality Group. UK audit of glomerular filtration rate measurement from plasma sampling in 2013. Nucl Med Commun. 2014;35(11):1096–106.
4. Jacobsson L. A method for the calculation of renal clearance based on a single plasma sample. Clin Physiol. 1983;3(4):297–305.
5. Fleming JS, Persaud L, Zivanovic MA. A general equation for estimating glomerular filtration rate from a single plasma sample. Nucl Med Commun. 2005;26(8):743–8.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献