国际共识支持制定测量肾小球滤过率(mGFR)的标准化方案,以促进临床和研究环境中mGFR测试的整合。为此,欧洲肾功能协会召集了一个具有mGFR相关经验的国际专家组。工作组进行了广泛的文献检索,以提供使用单室血浆清除模型和碘海醇作为外源性过滤标记物的mGFR测定建议的发展。选择碘海醇是因为它是非放射性标记的,便宜,安全,可以在中央实验室进行检测,和其他常用的非放射性标记的示踪剂已经(菊粉)或即将(碘代氨基甲酸酯)停用。选择血浆清除模型而不是尿液清除,因为它不需要尿液收集。一个隔室优于两个隔室,因为它需要较少的样品。这些建议基于已发表的证据,并辅以专家意见。共识文件涵盖了对患者和卫生专业人员的实用建议,准备,碘海醇的管理和安全方面,实验室分析,使用多个和单个样本方案的血液样本收集和采样时间,mGFR数学计算的描述以及实施策略。补充材料包括患者和提供者信息表,标准操作程序,研究方案模板,并支持mGFR计算。
International
consensus supports the development of standardized protocols for measured glomerular filtration rate (mGFR) to facilitate the integration of mGFR testing in both clinical and research settings. To this end, the European Kidney Function Consortium convened an international group of experts with relevant experience in mGFR. The working group performed an extensive literature search to inform the development of recommendations for mGFR determination using 1-compartment plasma clearance models and iohexol as the exogenous filtration marker. Iohexol was selected as it is non-radio labeled, inexpensive, and safe, can be assayed at a central laboratory, and the other commonly used non-radio-labeled tracers have been (inulin) or are soon to be (iothalamate) discontinued. A plasma clearance model was selected over urine clearance as it requires no urine collection. A 1 compartment was preferred to 2 compartments as it requires fewer samples. The recommendations are based on published evidence complemented by expert opinion. The
consensus paper covers practical advice for patients and health professionals, preparation, administration, and safety aspects of iohexol, laboratory analysis, blood sample collection and sampling times using both multiple and single-sample protocols, description of the mGFR mathematical calculations, as well as implementation strategies. Supplementary materials include patient and provider information sheets, standard operating procedures, a study protocol template, and support for mGFR calculation.