Anne C. Gomes , George B. Coura Filho , Luiz A. Gil Junior , Renato A. Caires , Emmanuel A. Burdmann , Carlos A. Buchpiguel , Veronica T. Costa e Silva , Marcelo T. Sapienza
{"title":"基于三个、两个和单个样本测量实体瘤患者肾小球滤过率的[51Cr]CrEDTA血浆清除率比较：前瞻性横断面分析。","authors":"Anne C. Gomes , George B. Coura Filho , Luiz A. Gil Junior , Renato A. Caires , Emmanuel A. Burdmann , Carlos A. Buchpiguel , Veronica T. Costa e Silva , Marcelo T. Sapienza","doi":"10.1016/j.clinsp.2024.100427","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>[<sup>51</sup>Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI).</p></div><div><h3>Methods</h3><p>1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [<sup>51</sup>Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods.</p></div><div><h3>Results</h3><p>Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m<sup>2</sup>. ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m<sup>2</sup> for all methods, except for SS methods in subgroups BMI > 40 kg/m<sup>2</sup>; GFR > 105 or < 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR < 45.</p></div><div><h3>Conclusion</h3><p>46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.</p></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"Article 100427"},"PeriodicalIF":2.2000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1807593224001042/pdfft?md5=b0dc14970dc906a28748994c3cd941e0&pid=1-s2.0-S1807593224001042-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Comparison of plasma clearance of [51Cr]CrEDTA based on three, two and single samples to measure the glomerular filtration rate in patients with solid tumors: a prospective cross-sectional analysis\",\"authors\":\"Anne C. Gomes , George B. Coura Filho , Luiz A. Gil Junior , Renato A. Caires , Emmanuel A. Burdmann , Carlos A. Buchpiguel , Veronica T. Costa e Silva , Marcelo T. Sapienza\",\"doi\":\"10.1016/j.clinsp.2024.100427\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>[<sup>51</sup>Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI).</p></div><div><h3>Methods</h3><p>1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [<sup>51</sup>Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods.</p></div><div><h3>Results</h3><p>Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m<sup>2</sup>. ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m<sup>2</sup> for all methods, except for SS methods in subgroups BMI > 40 kg/m<sup>2</sup>; GFR > 105 or < 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR < 45.</p></div><div><h3>Conclusion</h3><p>46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.</p></div>\",\"PeriodicalId\":10472,\"journal\":{\"name\":\"Clinics\",\"volume\":\"79 \",\"pages\":\"Article 100427\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1807593224001042/pdfft?md5=b0dc14970dc906a28748994c3cd941e0&pid=1-s2.0-S1807593224001042-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1807593224001042\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1807593224001042","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的：[51Cr]CrEDTA 可用于测量不同临床情况下的肾小球滤过率（GFR）。然而，对于测量其清除率所需的理想血液样本数量和时间点，目前还没有达成共识。本研究旨在比较测量实体瘤患者 GFR 的斜率截距法（SI）和单样本法（SS），并根据年龄、GFR 和体重指数（BMI）进行分层。在注射[51Cr]CrEDTA（246-GFR）后 2、4 和 6 小时抽取血样，采用 SI 法计算 GFR。此外，还使用 SI 法测量了 2 小时和 4 小时（24-GFR）以及 4 小时和 6 小时（46-GFR）的样本，并根据 Groth 法（4Gr-GFR）和 Fleming 法（4Fl-GFR）测量了 SS 法。对这些方法的准确性、精确性和偏差进行了统计分析：结果：246-GFR 平均值为 79.2 ± 21.9 mL/min/1.73 m2。方差分析表明，4Gr-GFR 与参考 246-GFR 之间存在明显差异。所有方法的偏差均低于 5 mL/min/1.73 m2，但在 BMI > 40 kg/m2; GFR > 105 或 < 45 的亚组中，SS 方法除外。除 GFR < 45 亚组的 SS 方法外，所有方法的精确度都足够高，30% 的准确度高于 98%：46-GFR和246-GFR的一致性很高，可用于评估实体瘤患者的肾功能。在特殊情况下，对于预期 GFR 正常的非肥胖患者，可采用单样本方法。
Comparison of plasma clearance of [51Cr]CrEDTA based on three, two and single samples to measure the glomerular filtration rate in patients with solid tumors: a prospective cross-sectional analysis
Objectives
[51Cr]CrEDTA is used to measure the Glomerular Filtration Rate (GFR) in different clinical conditions. However, there is no consensus on the ideal number of blood samples to be taken and at what time points to measure its clearance. This study aimed to compare Slope Intercept (SI) and Single-Sample (SS) methods for measuring GFR in patients with solid tumors, stratified by age, GFR, and Body Mass Index (BMI).
Methods
1,174 patients with cancer were enrolled in this prospective study. GFR was calculated by the SI method using blood samples drawn 2-, 4-, and 6-hours after [51Cr]CrEDTA injection (246-GFR). GFR was also measured using the SI method with samples at 2 and 4 hours (24-GFR) and at 4 and 6 hours (46-GFR), and SS methods according to Groth (4Gr-GFR) and Fleming (4Fl-GFR). Statistical analysis was performed to assess the accuracy, precision, and bias of the methods.
Results
Mean 246-GFR was 79.2 ± 21.9 mL/min/1.73 m2. ANOVA indicated a significant difference between 4Gr-GFR and the reference 246-GFR. Bias was lower than 5 mL/min/1.73 m2 for all methods, except for SS methods in subgroups BMI > 40 kg/m2; GFR > 105 or < 45. Precision was adequate and accuracy of 30 % was above 98% for all methods, except for SS methods in subgroup GFR < 45.
Conclusion
46-GFR and 246-GFR have high agreement and may be used to evaluate kidney function in patients with solid tumors. Single-sample methods can be adopted in specific situations, for non-obese patients with expected normal GFR.
期刊介绍：
CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
