• 1.

    Lulich JP, Osborne CA, Obrien TD, et al. Feline renal failure—questions, answers, questions. Compend Contin Educ Pract Vet 1992; 14: 127152.

    • Search Google Scholar
    • Export Citation
  • 2.

    Bailey DB, Rassnick KM, Prey JD, et al. Evaluation of serum iohexol clearance for use in predicting carboplatin clearance in cats. Am J Vet Res 2009; 70: 11351140.

    • Search Google Scholar
    • Export Citation
  • 3.

    Olsson B, Aulie A, Sveen K, et al. Human pharmacokinetics of iohexol. A new nonionic contrast medium. Invest Radiol 1983; 18: 177182.

  • 4.

    Krutzen E, Back SE, Nilsson-Ehle I, et al. Plasma clearance of a new contrast agent, iohexol: a method for the assessment of glomerular filtration rate. J Lab Clin Med 1984; 104: 955961.

    • Search Google Scholar
    • Export Citation
  • 5.

    Edelson J, Shaw D, Palace G. Pharmacokinetics of iohexol, a new nonionic radiocontrast agent, in humans. J Pharm Sci 1984; 73: 993995.

  • 6.

    Brown SA, Finco DR, Boudinot FD, et al. Evaluation of a single injection method, using iohexol, for estimating glomerular filtration rate in cats and dogs. Am J Vet Res 1996; 57: 105110.

    • Search Google Scholar
    • Export Citation
  • 7.

    Miyamoto K. Use of plasma clearance of iohexol for estimating glomerular filtration rate in cats. Am J Vet Res 2001; 62: 572575.

  • 8.

    Miyamoto K. Clinical application of plasma clearance of iohexol on feline patients. J Feline Med Surg 2001; 3: 143147.

  • 9.

    Haller M, Rohner K, Muller W, et al. Single-injection inulin clearance for routine measurement of glomerular filtration rate in cats. J Feline Med Surg 2003; 5: 175181.

    • Search Google Scholar
    • Export Citation
  • 10.

    Goy-Thollot I, Besse S, Garnier F, et al. Simplified methods for estimation of plasma clearance of iohexol in dogs and cats. J Vet Intern Med 2006; 20: 5256.

    • Search Google Scholar
    • Export Citation
  • 11.

    Goy-Thollot I, Chafotte C, Besse S, et al. Iohexol plasma clearance in healthy dogs and cats. Vet Radiol Ultrasound 2006; 47: 168173.

  • 12.

    van Hoek I, Vandermeulen E, Duchateau L, et al. Comparison and reproducibility of plasma clearance of exogenous creatinine, exo-iohexol, endo-iohexol, and 51Cr-EDTA in young adult and aged healthy cats. J Vet Intern Med 2007; 21: 950958.

    • Search Google Scholar
    • Export Citation
  • 13.

    Le Garreres A, Laroute V, De La Farge F, et al. Disposition of plasma creatinine in non-azotaemic and moderately azotaemic cats. J Feline Med Surg 2007; 9: 8996.

    • Search Google Scholar
    • Export Citation
  • 14.

    Heiene R, Reynolds BS, Bexfield NH, et al. Estimation of glomerular filtration rate via 2- and 4-sample plasma clearance of iohexol and creatinine in clinically normal cats. Am J Vet Res 2009; 70: 176185.

    • Search Google Scholar
    • Export Citation
  • 15.

    Goodman LA, Brown SA, Torres BT, et al. Effects of meloxicam on plasma iohexol clearance as a marker of glomerular filtration rate in conscious healthy cats. Am J Vet Res 2009; 70: 826830.

    • Search Google Scholar
    • Export Citation
  • 16.

    van Hoek IM, Lefebvre HP, Paepe D, et al. Comparison of plasma clearance of exogenous creatinine, exo-iohexol, and endoiohexol over a range of glomerular filtration rates expected in cats. J Feline Med Surg 2009; 11: 10281030.

    • Search Google Scholar
    • Export Citation
  • 17.

    van Hoek I, Lefebvre HP, Kooistra HS, et al. Plasma clearance of exogenous creatinine, exo-iohexol, and endo-iohexol in hyper-thyroid cats before and after treatment with radioiodine. J Vet Intern Med 2008; 22: 879885.

    • Search Google Scholar
    • Export Citation
  • 18.

    Foster SJ, Sovak M. Isomerism in iohexol and ioxilan. Analysis and implications. Invest Radiol 1988; 23 (suppl 1):S106S109.

  • 19.

    Jacobsen PB, Larsen A, Konarboland R, et al. Biotransformation of nonionic x-ray contrast agents in vivo and in vitro. Drug Metab Dispos 1999; 27: 12051213.

    • Search Google Scholar
    • Export Citation
  • 20.

    Brochner-Mortensen J. A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 1972; 30: 271274.

  • 21.

    Heiene R, Moe L. Pharmacokinetic aspects of measurement of glomerular filtration rate in the dog: a review. J Vet Intern Med 1998; 12: 401414.

    • Search Google Scholar
    • Export Citation
  • 22.

    Chantler C, Barratt TM. Estimation of glomerular filtration rate from plasma clearance of 51-chromium edetic acid. Arch Dis Child 1972; 47: 613617.

    • Search Google Scholar
    • Export Citation
  • 23.

    Brochner-Mortensen J, Haahr J, Christoffersen J. A simple method for accurate assessment of the glomerular filtration rate in children. Scand J Clin Lab Invest 1974; 33: 140143.

    • Search Google Scholar
    • Export Citation
  • 24.

    Heiene R, Moe L. The relationship between some plasma clearance methods for estimation of glomerular filtration rate in dogs with pyometra. J Vet Intern Med 1999; 13: 587596.

    • Search Google Scholar
    • Export Citation
  • 25.

    Watson AD, Lefebvre HP, Concordet D, et al. Plasma exogenous creatinine clearance test in dogs: comparison with other methods and proposed limited sampling strategy. J Vet Intern Med 2002; 16: 2233.

    • Search Google Scholar
    • Export Citation
  • 26.

    Sapirstein LA, Vidt DG, Mandel MJ, et al. Volumes of distribution and clearances of intravenously injected creatinine in the dog. Am J Physiol 1955; 181: 330336.

    • Search Google Scholar
    • Export Citation
  • 27.

    Yamaoka K, Nakagawa T, Uno T. Application of Akaike's information criterion (AIC) in the evaluation of linear pharmacokinetic equations. J Pharmacokinet Biopharm 1978; 6: 165175.

    • Search Google Scholar
    • Export Citation
  • 28.

    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307310.

  • 29.

    DiStefano JJ, 3rd. Noncompartmental vs. compartmental analysis: some bases for choice. Am J Physiol 1982; 243:R1R6.

  • 30.

    Peters AM. The kinetic basis of glomerular filtration rate measurement and new concepts of indexation to body size. Eur J Nucl Med Mol Imaging 2004; 31: 137149.

    • Search Google Scholar
    • Export Citation
  • 31.

    Gaspari F, Perico N, Ruggenenti P, et al. Plasma clearance of nonradioactive iohexol as a measure of glomerular filtration rate. J Am Soc Nephrol 1995; 6: 257263.

    • Search Google Scholar
    • Export Citation
  • 32.

    Bexfield NH, Heiene R, Gerritsen RJ, et al. Glomerular filtration rate estimated by 3-sample plasma clearance of iohexol in 118 healthy dogs. J Vet Intern Med 2008; 22: 6673.

    • Search Google Scholar
    • Export Citation
  • 33.

    Mutzel W, Speck U. Pharmacokinetics and biotransformation of iohexol in the rat and the dog. Acta Radiol Suppl 1980; 362: 8792.

  • 34.

    Laroute V, Lefebvre HP, Costes G, et al. Measurement of glomerular filtration rate and effective renal plasma flow in the conscious beagle dog by single intravenous bolus of iohexol and p-aminohippuric acid. J Pharmacol Toxicol Methods 1999; 41: 1725.

    • Search Google Scholar
    • Export Citation
  • 35.

    Finco DR, Braselton WE, Cooper TA. Relationship between plasma iohexol clearance and urinary exogenous creatinine clearance in dogs. J Vet Intern Med 2001; 15: 368373.

    • Search Google Scholar
    • Export Citation

Advertisement

Glomerular filtration rate estimation by use of a correction formula for slope-intercept plasma iohexol clearance in cats

Natalie C. Finch BVSc, PhD1, Harriet M. Syme BVetMed, PhD2, Jonathan Elliott MA, VetMB, PhD3, Adrien M. Peters MA, MD, DSc4, Robert Gerritsen DVM5, Siska Croubels Pharm PhD6, and Reidun Heiene DVM, PhD7
View More View Less
  • 1 Royal Veterinary College, University of London, London NW1 0TU, England.
  • | 2 Royal Veterinary College, University of London, London NW1 0TU, England.
  • | 3 Royal Veterinary College, University of London, London NW1 0TU, England.
  • | 4 Royal Sussex County Hospital, Eastern Rd, Brighton, East Sussex BN2 5BE, England.
  • | 5 Referral Clinic De Kompaan, Van Reeuwijkstraat 34, Ommen, The Netherlands.
  • | 6 Faculty of Veterinary Medicine, Ghent University, B - 9000 Ghent, Belgium.
  • | 7 Norwegian School of Veterinary Science, 0033 Oslo, Norway.

Abstract

Objective—To develop a formula for correcting slope-intercept plasma iohexol clearance in cats and to compare clearance of total iohexol (TIox), endo-iohexol (EnIox), and exo-iohexol (ExIox).

Animals—20 client-owned, healthy adult and geriatric cats.

Procedures—Plasma clearance of TIox was determined via multisample and slope-intercept methods. A multisample method was used to determine clearance for EnIox and ExIox. A second-order polynomial correction factor was derived by performing regression analysis of the multisample data with the slope-intercept data and forcing the regression line though the origin. Clearance corrected by use of the derived formula was compared with clearance corrected by use of Brochner-Mortensen human and Heiene canine formulae. Statistical testing was applied, and Bland-Altman plots were created to assess the degree of agreement between TIox, EnIox, and ExIox clearance.

Results—Mean ± SD iohexol clearance estimated via multisample and corrected slope-intercept methods was 2.16 ± 0.35 mL/min/kg and 2.14 ± 0.34 mL/min/kg, respectively. The derived feline correction formula was Clcorrected = (1.036 × Cluncorrected) – (0.062 × Cluncorrected2), in which Cl represents clearance. Results obtained by use of the 2 methods were in excellent agreement. Clearance corrected by use of the Heiene formula had a linear relationship with clearance corrected by use of the feline formula; however, the relationship of the feline formula with the Brochner-Mortensen formula was nonlinear. Agreement between TIox, EnIox, and ExIox clearance was excellent.

Conclusions and Clinical Relevance—The derived feline correction formula applied to slope-intercept plasma iohexol clearance accurately predicted multisample clearance in cats. Use of this technique offers an important advantage by reducing stress to cats associated with repeated blood sample collection and decreasing the costs of analysis.

Contributor Notes

Dr. Finch's present address is Small Animal Hospital, University of Bristol, Langford, Bristol BS40 5DU, England.

Presented at the American College of Veterinary Internal Medicine Forum, Anaheim, Calif, June 2010.

Address correspondence to Dr. Finch (natalie.finch@bristol.ac.uk).