title: Gamma-variate plasma clearance versus urinary plasma clearance of51Cr-EDTA in patients with cirrhosis with and without fluid retention.
abstract: In patients with fluid retention, the plasma clearance of51Cr-EDTA (Clexpobtained by multiexponential fit) may overestimate the glomerular filtration rate (GFR). The present study was undertaken to compare a gamma-variate plasma clearance (Clgv)with the urinary plasma clearance of51Cr-EDTA (Clu) in patients with cirrhosis with and without fluid retention. A total of 81 patients with cirrhosis (22 without fluid retention, 59 with ascites) received a quantitative intravenous injection of51Cr-EDTA followed by plasma and quantitative urinary samples for 5 h. Clgvwas determined from the injected dose relative to the plasma concentration-time area, obtained by a gamma-variate iterative fit. Clexpand Cluwere determined by standard technique. In patients without fluid retention, Clgv, Clexpand Cluwere closely similar. The difference between Clgvand Clu(Clgv- Clu= ΔCl) was mean -0·6 ml min-11·73 m-2. In patients with ascites, ΔCl was significantly higher (11·8 ml min-11·73 m-2, P<0·0001), but this value was lower than Clexp- Clu(17·5 mL min-11·73 m-2, P<0·01). ΔCl increased with lower values of GFR (P<0·001). In conclusion, in patients with fluid retention and ascites Clgvand Clexpoverestimates GFR substantially, but the overestimation is smaller with Clgv. Although Clumay underestimate GFR slightly, patients with ascites should collect urine quantitatively to obtain a reliable measurement of GFR.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, 239, Center for Functional and Diagnostic Imaging and Research, Copenhagen, Denmark.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fuglsang
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, 239, Center for Functional and Diagnostic Imaging and Research, Copenhagen, Denmark.
authors.forename: Ulrik L
authors.initials: UL
authors.lastname: Henriksen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, 239, Center for Functional and Diagnostic Imaging and Research, Copenhagen, Denmark.
authors.forename: Hanne B
authors.initials: HB
authors.lastname: Hansen
authors.affiliation: Gastro Unit, Medical Division, 439, Hvidovre Hospital and Medical and Health Faculty, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, 239, Center for Functional and Diagnostic Imaging and Research, Copenhagen, Denmark.
authors.forename: Jens H
authors.initials: JH
authors.lastname: Henriksen
mesh_terms: D001201:Ascites / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine; D002860:Chromium Radioisotopes; D004492:Edetic Acid / Q000008:administration & dosage* / Q000097:blood / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D006530:Hepatorenal Syndrome / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine; D006801:Humans; D007275:Injections, Intravenous; D007668:Kidney / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D011865:Radioisotope Dilution Technique; D015203:Reproducibility of Results; D016482:Urinalysis
chemical_list: D002860:Chromium Radioisotopes; D004492:Edetic Acid
keywords: ascites; curve fit of plasma concentration; delayed indicator distribution; glomerular filtration rate; interstitiel space; peritoneal clearance