Accuracy-Based Glomerular Filtration Rate Assessment by Plasma Iohexol Clearance in Kidney Transplant Donors

Authors

Zhicheng Jin
Rongrong Huang
Paul Christensen
Roger L Bertholf
Xin Yi

Language

English

Publication Date

9-19-2023

Journal

Journal of Clinical Medicine

DOI

10.3390/jcm12186054

PMID

37762993

PMCID

PMC10532236

PubMedCentral® Posted Date

9-19-2023

PubMedCentral® Full Text Version

Post-print

Abstract

Background: An accurate measurement of the glomerular filtration rate (GFR) is essential for detecting renal insufficiency in living kidney donors. Iohexol is a "near-ideal" exogenous filtration marker for GFR measurements that has attracted increasing interest in clinical practice because it is non-toxic, non-radioactive, readily available, and easy to measure. In this study, we aimed to set up a laboratory test to conveniently assess the plasma clearance of iohexol in living kidney donors.

Methods: A workflow was established in the institution's infusion clinic to administer iohexol and to collect three timed blood samples from renal transplant donors. Iohexol was thereafter measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The serum proteins were precipitated and the supernatant containing iohexol was diluted prior to the LC-MS/MS analysis. The LC-MS/MS method was developed on a Thermo Vanquish UHPLC coupled with a TSQ Endura triple quadruple mass spectrometer with a total run time of 2.5 min. The analytical performance of the method was assessed.

Results: The LC-MS/MS method demonstrated a good analytical performance. To calculate the iohexol clearance rate and the GFR, automated data integration and a result calculation were accomplished by using a custom Python script. Automated result reporting was achieved using a laboratory informatics system (LIS) vendor's direct media interface.

Conclusions: We developed and implemented a laboratory test to assess the plasma clearance of iohexol. A workflow was established in the hospital to reliably measure the GFR in living kidney donors, with a potential to be further expanded into other areas where an accurate GFR measurement is needed.

Keywords

glomerular filtration rate, plasma iohexol clearance, LC-MS/MS

Published Open-Access

yes

Recommended Citation

Jin, Zhicheng; Huang, Rongrong; Christensen, Paul; et al., "Accuracy-Based Glomerular Filtration Rate Assessment by Plasma Iohexol Clearance in Kidney Transplant Donors" (2023). Faculty and Staff Publications. 5650.
https://digitalcommons.library.tmc.edu/baylor_docs/5650