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Published on: May 10, 2013
Glomerular Filtration Rate Measured Based on Iomeprol Clearance Assessed at CT Urography in Living Kidney Donor
Thomas Stehlé1, Félix Wei1, Séverine Brabant1
1From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.).
Abstract:
Background Estimating glomerular filtration rate (GFR) from serum creatinine can be inaccurate, and current procedures for measuring GFR are time-consuming and cumbersome. Purpose To develop a method for measuring GFR based on iomeprol clearance assessed at CT urography in kidney donor candidates and compare this with iohexol clearance (reference standard for measuring GFR). Materials and Methods This cross-sectional retrospective study included data from kidney donor candidates who underwent both iohexol clearance and CT urography between July 2016 and October 2022. CT-measured GFR was calculated as the iomeprol excretion rate in the urinary system between arterial and excretory phases (Hounsfield units times milliliters per minute) divided by a surrogate for serum iomeprol concentration in the aorta at the midpoint (in Hounsfield units). Performance of CT-measured GFR was assessed with use of mean bias (mean difference between CT-measured GFR and iohexol clearance), precision (the distance between quartile 1 and quartile 3 of the bias [quartile 3 minus quartile 1], with a small value indicating high precision), and accuracy (percentage of CT-measured GFR values falling within 10%, 20%, and 30% of iohexol clearance values). Intraobserver agreement was assessed for 30 randomly selected individuals with the Lin concordance correlation coefficient. Results A total of 75 kidney donor candidates were included (mean age, 51 years ± 13 [SD]; 45 female). The CT-measured GFR was unbiased (1.1 mL/min/1.73 m2 [95% CI: -1.9, 4.1]) and highly precise (16.2 mL/min/1.73 m2 [quartiles 1 to 3, -6.6 to 9.6]). The accuracy of CT-measured GFR within 10%, 20%, and 30% was 61.3% (95% CI: 50.3, 72.4), 88.0% (95% CI: 80.7, 95.4), and 100%, respectively. Concordance between CT-based GFR measurements taken 2 months apart was almost perfect (correlation coefficient, 0.99 [95% CI: 0.98, 0.99]). Conclusion In living kidney donors, GFR measured based on iomeprol clearance assessed at CT urography showed good agreement with GFR measured based on iohexol clearance. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Davenport in this issue.
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