New sampling strategy using a Bayesian approach to assess iohexol clearance in kidney transplant recipients

Therapeutic Drug Monitoring
I Benz-de BretagneH Blasco

Abstract

Glomerular filtration rate (GFR) measurement is a major issue in kidney transplant recipients for clinicians. GFR can be determined by estimating the plasma clearance of iohexol, a nonradiolabeled compound. For practical and convenient application for patients and caregivers, it is important that a minimal number of samples are drawn. The aim of this study was to develop and validate a Bayesian model with fewer samples for reliable prediction of GFR in kidney transplant recipients. Iohexol plasma concentration-time curves from 95 patients were divided into an index (n = 63) and a validation set (n = 32). Samples (n = 4-6 per patient) were obtained during the elimination phase, that is, between 120 and 270 minutes. Individual reference values of iohexol clearance (CL(iohexol)) were calculated from k (elimination slope) and V (volume of distribution from intercept). Individual CL(iohexol) values were then introduced into the Bröchner-Mortensen equation to obtain the GFR (reference value). A population pharmacokinetic model was developed from the index set and validated using standard methods. For the validation set, we tested various combinations of 1, 2, or 3 sampling time to estimate CL(iohexol). According to the different comb...Continue Reading

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Citations

Feb 28, 2017·Nature Reviews. Nephrology·Lakhmir S ChawlaUNKNOWN Acute Disease Quality Initiative Workgroup 16.
Jul 16, 2019·Critical Care Medicine·Charlotte Salmon GandonnièreUNKNOWN Clinical Research in Intensive Care and Sepsis - TRIal Group for Global Evaluation and Research in SEPsis (CRICS-TriggerSep)
May 12, 2016·Clinical Chemistry and Laboratory Medicine : CCLM·Charlotte Salmon-GandonnièreChantal Barin-Le Guellec

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