Creatinine clearance after cimetidine administration in a new short procedure: comparison with plasma and renal clearances of iohexol.

GFR measurement cimetidine creatinine clearance iohexol plasma clearance iohexol renal clearance

Journal

Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321

Informations de publication

Date de publication:
Aug 2020
Historique:
received: 06 03 2019
accepted: 02 06 2019
entrez: 9 9 2020
pubmed: 21 7 2019
medline: 21 7 2019
Statut: epublish

Résumé

Creatinine clearance after cimetidine administration (Cim-CreatClr) was once proposed as a method of glomerular filtration rate (GFR) measurement, but has been largely abandoned. We investigated whether a new short procedure for Cim-CreatClr determination could be considered an appropriate method for GFR measurement. A 150-min protocol involving oral cimetidine administration was developed to determine Cim-CreatClr. In total, 168 patients underwent simultaneous assessments of creatinine clearance before and after cimetidine administration [basal creatinine clearance (Basal-CreatClr) and Cim-CreatClr, respectively], renal iohexol clearance and plasma iohexol clearance (R-iohexClr and P-iohexClr, respectively). We compared the agreement between the various methods of GFR measurement, using Bland-Altman plots to determine biases, precisions (standard deviation of the biases) and accuracy (proportions of GFR values falling within 10, 15 and 30% of the mean: P10, P15 and P30, respectively). After cimetidine administration, Basal-CreatClr decreased by 19.8% [95% reference limits of agreement (95% LoA): -2.2 to 41.7%]. The bias between Cim-CreatClr and P-iohexClr was -0.6% (95% LoA -26.8 to 28%); the precision was 14.0%; P10, P15 and P30 were 57.1% [95% confidence interval (95% CI) 49.3 to 64.7%], 73.2% (95% CI 65.8 to 79.7%) and 97.0% (95% CI 93.2 to 99.0%), respectively. Due to the positive bias (16.7%; 95% LoA -3.6 to 36.9%) of Cim-CreatClr relative to R-iohexClr, accuracy of Cim-CreatClr relative to R-iohexClr was poor despite a good precision (10.3%). Our study shows a high level of agreement between Cim-CreatClr and P-iohexClr. These results suggest that this short Cim-CreatClr procedure is a valid method for GFR measurement, which might be useful, in particular, in situations in which P-iohexClr is not suitable or not available.

Sections du résumé

BACKGROUND BACKGROUND
Creatinine clearance after cimetidine administration (Cim-CreatClr) was once proposed as a method of glomerular filtration rate (GFR) measurement, but has been largely abandoned. We investigated whether a new short procedure for Cim-CreatClr determination could be considered an appropriate method for GFR measurement.
METHODS METHODS
A 150-min protocol involving oral cimetidine administration was developed to determine Cim-CreatClr. In total, 168 patients underwent simultaneous assessments of creatinine clearance before and after cimetidine administration [basal creatinine clearance (Basal-CreatClr) and Cim-CreatClr, respectively], renal iohexol clearance and plasma iohexol clearance (R-iohexClr and P-iohexClr, respectively). We compared the agreement between the various methods of GFR measurement, using Bland-Altman plots to determine biases, precisions (standard deviation of the biases) and accuracy (proportions of GFR values falling within 10, 15 and 30% of the mean: P10, P15 and P30, respectively).
RESULTS RESULTS
After cimetidine administration, Basal-CreatClr decreased by 19.8% [95% reference limits of agreement (95% LoA): -2.2 to 41.7%]. The bias between Cim-CreatClr and P-iohexClr was -0.6% (95% LoA -26.8 to 28%); the precision was 14.0%; P10, P15 and P30 were 57.1% [95% confidence interval (95% CI) 49.3 to 64.7%], 73.2% (95% CI 65.8 to 79.7%) and 97.0% (95% CI 93.2 to 99.0%), respectively. Due to the positive bias (16.7%; 95% LoA -3.6 to 36.9%) of Cim-CreatClr relative to R-iohexClr, accuracy of Cim-CreatClr relative to R-iohexClr was poor despite a good precision (10.3%).
CONCLUSIONS CONCLUSIONS
Our study shows a high level of agreement between Cim-CreatClr and P-iohexClr. These results suggest that this short Cim-CreatClr procedure is a valid method for GFR measurement, which might be useful, in particular, in situations in which P-iohexClr is not suitable or not available.

Identifiants

DOI: 10.1093/ckj/sfz087 PMID: 32905173 PMC: PMC7467603
pubmed: 32905173
doi: 10.1093/ckj/sfz087
pii: sfz087
pmc: PMC7467603
doi:

Types de publication

Journal Article

Langues

eng

Pagination

587-596

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.

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Auteurs

Thomas Stehlé (T)

Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Service de Néphrologie et Transplantation, Creteil, France.
Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Équipe 21, Créteil, France.

Khalil El Karoui (K)

Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Service de Néphrologie et Transplantation, Creteil, France.
Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Équipe 21, Créteil, France.

Mehdi Sakka (M)

AP-HP Groupe Hospitalier Henri-Mondor/Albert Chenevier, Laboratoire de Biochimie Pharmacologie et Toxicologie, Créteil, France, AP-HP (Assistance Publique-Hôpitaux de Paris), Creteil, France.

Ahmad Ismail (A)

AP-HP Groupe Hospitalier Henri-Mondor/Albert Chenevier, Laboratoire de Biochimie Pharmacologie et Toxicologie, Créteil, France, AP-HP (Assistance Publique-Hôpitaux de Paris), Creteil, France.

Marie Matignon (M)

Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Service de Néphrologie et Transplantation, Creteil, France.
Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Équipe 21, Créteil, France.

Philippe Grimbert (P)

Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Service de Néphrologie et Transplantation, Creteil, France.
Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Équipe 21, Créteil, France.

Florence Canoui-Poitrine (F)

Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Département de Santé Publique/Recherche Clinique (URC-Mondor), Creteil, France.
Université Paris Est Créteil (UPEC), DHU (Département Hospitalo-Universitaire) A-TVB, Institut Mondor de Recherche Biomédicale (IMRB) - EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Créteil, France.

Dominique Prié (D)

AP-HP, Groupe Hospitalier Necker Enfants Malades, Service de Physiologie et Explorations Fonctionnelles, Paris, France.
Université Paris Descartes, Faculté de Médecine, Institut National de la Santé et de la Recherche Médicale (INSERM) U1151, Paris, France.

Vincent Audard (V)

Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Service de Néphrologie et Transplantation, Creteil, France.
Université Paris Est Créteil (UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Équipe 21, Créteil, France.

Classifications MeSH