Iohexol plasma and urinary concentrations in cirrhotic patients:A pilot study  

作　　者：Paul Carrier Alexandre Destere Baptiste Giguet Marilyne Debette-Gratien Marie Essig Caroline Monchaud Jean-Baptiste Woillard Véronique Loustaud-Ratti 

机构地区：[1]Department of Liver Disease,Limoges University Hospital Center,U1248,INSERM,F-87000,Limoges,France [2]Department of Pharmacology,Toxicology and Centre of Pharmacovigilance,Limoges University Hospital Center,U1248,INSERM,F-87000,Limoges,France

出　　处：《World Journal of Hepatology》2022年第8期1621-1632,共12页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Renal failure is an independent prognostic factor for survival in patients with cirrhosis.Equations to calculate serum creatinine significantly overestimate the glomerular filtration rate(GFR).Plasma clearance of direct biomarkers has been used to improve the accuracy of evaluations of GFR in this population,but no study has simultaneously measured plasma and urinary clearance,which is the gold standard.AIM To study calculated plasma and urinary concentrations of iohexol,based on the kinetics of samples collected over 24 h from cirrhotic patients with three different grades of ascites.METHODS One dose of iohexol(5 mL)was injected intravenously and plasma concentrations were measured 11 times over 24 h in nine cirrhotic patients.The urinary concentration of iohexol was also measured,in urine collected at 4,8,12 and 24 h.RESULTS The plasma and urinary curves of iohexol were similar;however,incomplete urinary excretion was detected at 24 h.Within the estimated GFR limits of our population(>30 and<120 mL/min/1.73 m^(2)),the median measured GFR(m GFR)was 63.7 mL/min/1.73 m^(2)(range:41.3–111.3 mL/min/1.73 m^(2)),which was an accurate reflection of the actual GFR.Creatinine-based formulas for estimatingGFR showed significant bias and imprecision,while the Brochner–Mortensen(BM)equation accurately estimated the m GFR(r=0.93).CONCLUSION Plasma clearance of iohexol seems useful for determining GFR regardless of the ascites grade.We will secondly devise a pharmacokinetics model requiring fewer samples andvalidate the BM equation.

关 键 词：CIRRHOSIS Glomerular filtration Rate IOHEXOL PHARMACOKINETICS Brochner-Mortensen 

分 类 号：R575.2[医药卫生—消化系统]