The reliability of glomerular filtration rate measured from plasma clearance: a multi-centre study of 1,878 healthy potential renal transplant donors

Purpose The objective of the study was to undertake a clinical audit of departmental performance in the measurement of glomerular filtration rate (GFR) using the coefficient of variation (CV) of extracellular fluid volume (ECFV) as the benchmark. ECFV is held within narrow limits in healthy subjects...

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Published in:European journal of nuclear medicine and molecular imaging 2012-04, Vol.39 (4), p.715-722
Main Authors: Peters, A. Michael, Howard, Bethany, Neilly, Mark D. J., Seshadri, Nagabhushan, Sobnack, Ravin, Hooker, Claire A., Irwin, Andrew, Snelling, Hayley, Gruning, Thomas, Perry, Laura, Patel, Neva H., Lawson, Richard S., Shabo, Gregory, Williams, Nigel, Dave, Surendra, Barnfield, Mark C
Format: Article
Language:English
Subjects:
Adult
Aged
Benchmarking
Body Mass Index
Body Weight
Cardiology
Data processing
Donors
Extracellular Fluid - metabolism
Female
Glomerular Filtration Rate
Health
Humans
Imaging
Kidney diseases
Kidney Transplantation
Living Donors
Male
Medicine
Medicine & Public Health
Metabolic Clearance Rate
Middle Aged
Nuclear Medicine
Oncology
Original Article
Orthopedics
Plasma
Radiology
Reproducibility of Results
Retrospective Studies
Sex Factors
Surface area
Young Adult
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Summary:Purpose The objective of the study was to undertake a clinical audit of departmental performance in the measurement of glomerular filtration rate (GFR) using the coefficient of variation (CV) of extracellular fluid volume (ECFV) as the benchmark. ECFV is held within narrow limits in healthy subjects, narrower than GFR, and should therefore have a low CV. Methods Fifteen departments participated in this retrospective study of healthy renal transplant donors. Data were analysed separately for men ( n ranged from 28 to 115 per centre; total = 819) and women ( n  = 28–146; 1,059). All centres used the slope-intercept method with blood sample numbers ranging from two to five. Subjects did not fast prior to GFR measurement. GFR was scaled to body surface area (BSA) and corrected for the single compartment assumption. GFR scaled to ECFV was calculated as the terminal slope rate constant and corrected for the single compartment assumption. ECFV/BSA was calculated as the ratio of GFR/BSA to GFR/ECFV. Results The departmental CVs of ECFV/BSA and GFR/BSA ranged from 8.3 to 25.8% and 12.8 to 21.9%, respectively, in men, and from 9.6 to 21.1% and 14.8 to 23.7%, respectively, in women. Both CVs correlated strongly between men and women from the same centre, suggesting department-specific systematic errors. GFR/BSA was higher in men in 14 of 15 centres, whereas GFR/ECFV was higher in women in 14 of 15 centres. Both correlated strongly between men and women, suggesting regional variation in GFR. Conclusion The CV of ECFV/BSA in normal subjects is a useful indicator of the technical robustness with which GFR is measured and, in this study, indicated a wide variation in departmental performance.
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-011-2024-5