title: Simple sampling strategy for measuring inulin renal clearance.
abstract: BACKGROUND
  In the standard method of inulin clearance (Cin), three sets of serum and urine samples are collected during a 2-hour clearance period. For a practical use of this method, sampling should be the minimal number allowable while still providing enough accuracy. The aim of this study was to evaluate the validity of inulin renal clearance with assumed single urine collection with a period such as 30, 60 or 90 minutes.
  
  
  METHODS
  Inulin clearance data collected by the standard method from 737 individuals were used. Changes of serum inulin concentrations between 45 and 105 minutes after the start of the infusion were analyzed. We used first urine collection to calculate the inulin clearance with single urine collection (Cin-30 min). We assumed single urine collection for 60 or 90 minutes by combining the urine data of the consecutive 30-minute periods. Inulin clearances (Cin-60 min, Cin-90 min) were calculated from the assumed single urine collections, respectively.
  
  
  RESULTS
  Serum inulin concentration did not reach equilibrium during the clearance period. It increased in subjects with low glomerular filtration rate (GFR) and decreased in subjects with normal GFR. The amount of the change was small and -0.5 +/- 12.6% in subjects with GFR over 30 ml/min per 1.73 m(2). Cin-30 min, Cin-60 min and Cin-90 min showed high correlation coefficients against Cin-ST (0.962, 0.988 and 0.998, respectively). Systemic biases in these clearances were negligible (under 1 ml/min per 1.73 m(2)). Root mean square error (RMSE) were 10.4, 5.3 and 2.3 ml/min per 1.73 m(2) for Cin-30 min, Cin-60 min and Cin-90 min, respectively. These data indicated that accuracy of inulin clearance depends on the duration of the urine collection period.
  
  
  CONCLUSIONS
  Inulin clearance with a single urine collection is a convenient method. We showed that single urine collection for 30 minutes or a longer period has reasonable accuracy in calculation of inulin clearance. We propose a method of inulin clearance with single urine collection for 60 minutes.
authors.affiliation: Department of Functional Diagnostic Science, Course of Health Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. horio@sahs.med.osaka-u.ac.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Horio
authors.forename: Enyu
authors.initials: E
authors.lastname: Imai
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Akira
authors.initials: A
authors.lastname: Hishida
authors.forename: Seiichi
authors.initials: S
authors.lastname: Matsuo
mesh_terms: D005919:Glomerular Filtration Rate; D006801:Humans; D007262:Infusions, Intravenous; D007444:Inulin / Q000008:administration & dosage / Q000097:blood / Q000652:urine; D007668:Kidney / Q000378:metabolism*; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D008954:Models, Biological; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013997:Time Factors
chemical_list: D007444:Inulin