title: UK audit of glomerular filtration rate measurement from plasma sampling in 2013.
abstract: BACKGROUND
  An audit was carried out into UK glomerular filtration rate (GFR) calculation. The results were compared with an identical 2001 audit.
  
  
  METHODS
  Participants used their routine method to calculate GFR for 20 data sets (four plasma samples) in millilitres per minute and also the GFR normalized for body surface area. Some unsound data sets were included to analyse the applied quality control (QC) methods. Variability between centres was assessed for each data set, compared with the national median and a reference value calculated using the method recommended in the British Nuclear Medicine Society guidelines. The influence of the number of samples on variability was studied. Supplementary data were requested on workload and methodology.
  
  
  RESULTS
  The 59 returns showed widespread standardization. The applied early exponential clearance correction was the main contributor to the observed variability. These corrections were applied by 97% of centres (50% - 2001) with 80% using the recommended averaged Brochner-Mortenson correction. Approximately 75% applied the recommended Haycock body surface area formula for adults (78% for children). The effect of the number of samples used was not significant. There was wide variability in the applied QC techniques, especially in terms of the use of the volume of distribution.
  
  
  CONCLUSIONS
  The widespread adoption of the guidelines has harmonized national GFR calculation compared with the previous audit. Further standardization could further reduce variability. This audit has highlighted the need to address the national standardization of QC methods. Radionuclide techniques are confirmed as the preferred method for GFR measurement when an unequivocal result is required.
authors.affiliation: aDepartment of Medical and Sport Sciences, University of Cumbria, Lancaster bDepartment of Nuclear Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester cDepartment of Medical Physics and Bioengineering, Royal United Hospital Bath NHS Trust, Bath dDepartment of Medical Physics and Bioengineering, University Hospitals Bristol NHS Foundation Trust, Bristol eLink Medical, Bramshill fDepartment of Nuclear Medicine, Poole Hospital NHS Foundation Trust, Poole gDepartment of Nuclear Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield hRadiological Sciences Unit, Imperial College Healthcare NHS Trust, London iDepartment of Nuclear Medicine, Barnsley Hospital NHS Foundation Trust, Barnsley, UK jDepartment of Nuclear Medicine, St Luke's Hospital, Dublin, Ireland.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Murray
authors.forename: Richard S
authors.initials: RS
authors.lastname: Lawson
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Cade
authors.forename: David O
authors.initials: DO
authors.lastname: Hall
authors.forename: Bob
authors.initials: B
authors.lastname: Kenny
authors.forename: Emma
authors.initials: E
authors.lastname: O'Shaughnessy
authors.forename: Jon
authors.initials: J
authors.lastname: Taylor
authors.forename: David
authors.initials: D
authors.lastname: Towey
authors.forename: Duncan
authors.initials: D
authors.lastname: White
authors.forename: Kathryn
authors.initials: K
authors.lastname: Carson
mesh_terms: D000328:Adult; D002648:Child; D054869:Clinical Audit; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010949:Plasma / Q000378:metabolism*; D017410:Practice Guidelines as Topic; D011786:Quality Control; D006113:United Kingdom