Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination

Abstract Measurement of glomerular filtration rate (GFR) in children by iohexol injection and blood sampling from the contralateral arm is widely used. A single intravenous access for iohexol injection and subsequent blood sampling has the obvious advantages of being less painful and easier to perfo...

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Autores principales:	Thea Tislevoll Eide, Karl Ove Hufthammer, Atle Brun, Damien Brackman, Einar Svarstad, Camilla Tøndel
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/493e1ab0acb948d2bb7e7a3ee96f6c26
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spelling	oai:doaj.org-article:493e1ab0acb948d2bb7e7a3ee96f6c262021-12-05T12:13:08ZAccuracy of single intravenous access iohexol GFR in children is hampered by marker contamination10.1038/s41598-021-02759-12045-2322https://doaj.org/article/493e1ab0acb948d2bb7e7a3ee96f6c262021-12-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-02759-1https://doaj.org/toc/2045-2322Abstract Measurement of glomerular filtration rate (GFR) in children by iohexol injection and blood sampling from the contralateral arm is widely used. A single intravenous access for iohexol injection and subsequent blood sampling has the obvious advantages of being less painful and easier to perform. The purpose of our study was to determine if blood samples drawn from the injection access are feasible and accurate for iohexol GFR (iGFR) measurements. Thirty-one children, median age 10.5 (range 6–17) years, with chronic kidney disease were given a bolus of iohexol followed by extended saline flushing and subsequent venous blood samples collected from the injection access as well as from a cannula in the contralateral arm, the latter serving as the reference method. Paired venous blood samples were collected at four time points (2, 3, 3.5 and 4 h) after the iohexol bolus. Blood sample discarding preceded and saline flushing followed each blood sampling to avoid marker contamination. iGFR based on samples drawn from the injection access at 2 and 3 h showed significantly lower iGFR than measurement from the contralateral arm (p < 0.01). Singlepoint iGFR did not differ significantly after 3–4 repeated procedures of blood discarding and saline flusing (3.5 and 4 h). Despite thorough saline flushing there is still a relatively high risk of falsely low iGFR due to marker contamination in blood samples from the injection site. Hence, blood sampling from a second intravenous access is recommended for routine iohexol GFR measurements in children. Clinical trial registration: ClinicalTrials.gov, Identifier NCT01092260, https://clinicaltrials.gov/ct2/show/NCT01092260?term=tondel&rank=2 .Thea Tislevoll EideKarl Ove HufthammerAtle BrunDamien BrackmanEinar SvarstadCamilla TøndelNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thea Tislevoll Eide Karl Ove Hufthammer Atle Brun Damien Brackman Einar Svarstad Camilla Tøndel Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination
description	Abstract Measurement of glomerular filtration rate (GFR) in children by iohexol injection and blood sampling from the contralateral arm is widely used. A single intravenous access for iohexol injection and subsequent blood sampling has the obvious advantages of being less painful and easier to perform. The purpose of our study was to determine if blood samples drawn from the injection access are feasible and accurate for iohexol GFR (iGFR) measurements. Thirty-one children, median age 10.5 (range 6–17) years, with chronic kidney disease were given a bolus of iohexol followed by extended saline flushing and subsequent venous blood samples collected from the injection access as well as from a cannula in the contralateral arm, the latter serving as the reference method. Paired venous blood samples were collected at four time points (2, 3, 3.5 and 4 h) after the iohexol bolus. Blood sample discarding preceded and saline flushing followed each blood sampling to avoid marker contamination. iGFR based on samples drawn from the injection access at 2 and 3 h showed significantly lower iGFR than measurement from the contralateral arm (p < 0.01). Singlepoint iGFR did not differ significantly after 3–4 repeated procedures of blood discarding and saline flusing (3.5 and 4 h). Despite thorough saline flushing there is still a relatively high risk of falsely low iGFR due to marker contamination in blood samples from the injection site. Hence, blood sampling from a second intravenous access is recommended for routine iohexol GFR measurements in children. Clinical trial registration: ClinicalTrials.gov, Identifier NCT01092260, https://clinicaltrials.gov/ct2/show/NCT01092260?term=tondel&rank=2 .
format	article
author	Thea Tislevoll Eide Karl Ove Hufthammer Atle Brun Damien Brackman Einar Svarstad Camilla Tøndel
author_facet	Thea Tislevoll Eide Karl Ove Hufthammer Atle Brun Damien Brackman Einar Svarstad Camilla Tøndel
author_sort	Thea Tislevoll Eide
title	Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination
title_short	Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination
title_full	Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination
title_fullStr	Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination
title_full_unstemmed	Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination
title_sort	accuracy of single intravenous access iohexol gfr in children is hampered by marker contamination
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/493e1ab0acb948d2bb7e7a3ee96f6c26
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Accuracy of single intravenous access iohexol GFR in children is hampered by marker contamination

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