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dc.contributor.authorHoulihan, Christine Aen
dc.contributor.authorJenkins, Margaret Aen
dc.contributor.authorOsicka, Tanya Men
dc.contributor.authorScott, Andrew Men
dc.contributor.authorParkin, John Desmonden
dc.contributor.authorJerums, Georgeen
dc.identifier.citationAustralian and New Zealand Journal of Medicine; 29(5): 693-700en
dc.description.abstractChanges in glomerular filtration rate (GFR) provide a valuable indicator of the progression of diabetic nephropathy. GFR is most commonly measured by the plasma clearance of radioisotopes, however, use of iohexol, a non-ionic radiocontrast medium, is a recently described alternative and has shown good agreement with inulin clearance. A one-compartment model is used for calculating GFR in most Australian centres but a two-compartment model is more accurate.To set up a non-radioisotopic method for assessment of GFR using iohexol, and to compare this with the currently used 99mTc-diethylene-triamine-penta-acetic acid (DTPA) method. Secondly, to compare GFR results using an unmodified one-compartment model with a one-compartment model subjected to the Brochner-Mortensen modification.Twenty-one patients with diabetes had assessment of GFR with simultaneous measurements of 99mTc-DTPA and iohexol plasma clearance. Plasma clearance was determined by the slope intercept method and then modified according to the Brochner-Mortensen equation. Plasma iohexol concentrations were determined by capillary electrophoresis.There was no significant difference between iohexol and 99mTc-DTPA derived GFR values, difference 4.3+/-7.7 mL/minute (mean+/-SD). This was despite 99mTc-DTPA protein binding demonstrated in the range of 5-10%. Comparison of GFR results using an unmodified one-compartment model with a Brochner-Mortensen corrected one-compartment model showed higher GFR values with the former, in the range of 20-30% for GFR values > 100 mL/minute.Iohexol provides an efficient alternative to radioisotopic methods for serial measurement of GFR in diabetic patients with hyperfiltration, incipient and overt nephropathy. A one-compartment model with its inherent overestimation of GFR should be replaced by the Brochner-Mortensen modified one-compartment model.en
dc.subject.otherContrast Mediaen
dc.subject.otherDiabetes Mellitus.blood.physiopathologyen
dc.subject.otherElectrophoresis, Capillaryen
dc.subject.otherGlomerular Filtration Rateen
dc.subject.otherIohexol.diagnostic useen
dc.subject.otherMetabolic Clearance Rateen
dc.subject.otherMiddle Ageden
dc.subject.otherTechnetium Tc 99m Pentetate.blood.diagnostic useen
dc.titleA comparison of the plasma disappearance of iohexol and 99mTc-DTPA for the measurement of glomerular filtration rate (GFR) in diabetes.en
dc.typeJournal Articleen
dc.identifier.journaltitleAustralian and New Zealand Journal of Medicineen
dc.identifier.affiliationDepartment of Medicine, University of Melbourne, Austin and Repatriation Medical Centre, Vic.en
dc.type.austinJournal Articleen
item.openairetypeJournal Article-
item.fulltextNo Fulltext- Imaging and Therapy- Newton-John Cancer Research Institute-
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