Kidney Week

Abstract: FR-PO1106

Iohexol Plasma Clearance Measurement Protocol Standardization: A Consensus of the European Kidney Function Consortium

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Ebert, Natalie, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany

Natalie Ebert, MD, MPH

• Schaeffner, Elke, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany

Elke Schaeffner, MD, MS

• Shafi, Tariq, Houston Methodist, Houston, Texas, United States

Tariq Shafi, MBBS, MHS, FASN

• Eriksen, Bjorn Odvar, UiT Norges Arktiske Universitet, Tromso, Norway

Bjorn Odvar Eriksen, MD, DrMed, PhD

• Bokenkamp, Arend, Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, Netherlands

Arend Bokenkamp, MD, PhD, FASN

• van Londen, Marco, Rijksuniversiteit Groningen, Groningen, Groningen, Netherlands

Marco van Londen, MD, PhD

• Seegmiller, Jesse C., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States

Jesse C. Seegmiller, PhD

• Palsson, Runolfur, Landspitali, Reykjavik, Capital, Iceland

Runolfur Palsson, MD, FASN

• Indridason, Olafur S., Landspitali, Reykjavik, Capital, Iceland

Olafur S. Indridason, MD, MS

• Delanaye, Pierre, CHU de Liege - Hopital du Sart Tilman, Liege, Liège, Belgium

Pierre Delanaye, MD, PhD

• Cavalier, Etienne, Universite de Liege, Liege, Belgium

Etienne Cavalier, PharmD, PhD

• Dubourg, Laurence, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes , France

Laurence Dubourg, MD, PhD

• White, Christine A., Queen's University, Kingston, Ontario, Canada

Christine A. White, MD, MS, MSc

Group or Team Name

• European Kidney Function Consortium (EKFC).

Background

International consensus and the 2024 KDIGO guidelines supports the development of standardized protocols for measured glomerular filtration rate (mGFR) to facilitate the adoption of mGFR in both clinical and research settings.

Methods

The European Kidney Function Consortium (EKFC) convened an international group of mGFR experts and performed an extensive literature search to inform the development of recommendations for mGFR determination using one-compartment plasma clearance models and iohexol as the exogenous filtration marker. Iohexol was selected as it is non-radiolabeled, safe, inexpensive, widely available, and can be assayed at a central laboratory. Other commonly used non-radio labeled tracers have been (inulin) or are soon to be (iothalamate) discontinued. A plasma clearance model was selected as it does not require timed urine collections. A one-compartment model was preferred to a two-compartment model as it requires fewer samples. The resulting recommendations were based on published evidence complemented by expert opinion.

Results

Recommendations include practical advice for patients and health professionals, preparation, administration and safety aspects of iohexol, laboratory analysis, blood sample collection and sample timing for both multiple and single sample protocols, description of the mGFR mathematical calculations as well as implementation strategies (Figure). The EKFC will provide materials such as patient information sheets, standard operating procedures, a study protocol template, and support for mGFR calculation.

Conclusion

Members of the EKFC have evaluated the evidence and formulated recommendations that include all aspects of iohexol plasma clearance measurement using a one-compartment model. Nephrologist education and widespread dissemination is critical to making mGFR available for patient care and research.