Glomerular filtration rate measurement by 'single-shot' injection of inulin

Abstract

In 14 ADPKD patients the total body clearance and the urinary clearance of inulin using the constant infusion method were compared with the 'single-shot' technique. Triplicate measurements of both clearances by each infusion method were obtained in 12 out of 14 patients. A high correlation was found between the total body clearance and the urinary clearance for both the constant infusion method (r = 0.96) and the single injection technique (r = 0.96). The coefficient of variation for the total body clearance of inulin was significantly lower for the constant infusion method and the single injection technique (7.8% and 7.1%) than for the urinary clearance of inulin (11.3% vs. 9.7%, P < 0.05). A constant overestimation of the urinary clearance by the total body clearance was observed with both methods (constant infusion method 8.3 ml · min-1 · 1.73 m-2 and single injection technique 13.4 ml · min-1 · 1.73 m-2). No concentration-dependent clearance was present. Determination of plasma inulin, especially at low levels, showed substantial interference by glucose. We conclude that, taking into account a constant overestimate of urinary clearance by the total body clearance of inulin, the single injection total body clearance possesses the best reproducibility and shows a good agreement with the conventional urinary clearance, which can be calculated by: GFR = TBCLss - 13.1 ml · min-1 · 1.73 m-2 (in the range of 28 to 124 ml · min-1 · 1.73 m-2).