The Effect of Improved Modelling of Plasma Clearance in Paediatric Patients with Expanded Body Spaces on Estimation of the Glomerular Filtration Rate

Claire Evans, A. S. Perkinson, M. T. Burniston, S. W. Smye

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

The glomerular filtration rate (GFR) is used clinically to assess renal function. The most accurate estimation technique is tracer clearance where deterministic compartment pharmacokinetic models are most widely used. The aim of this study was to assess the viability of alternative pharmacokinetic models to describe tracer clearance, and in turn, measure GFR. This study was carried out on 126 clearance datasets obtained from 44 patients with large solid tumours; these were fitted to four pharmacokinetic models with superiority of model determined by Akaike Information Criteria. A fractal model was found to be superior to the best deterministic compartment model (70% of datasets, P < 0.0020) as was a gamma-distributed residence time model (93% of datasets, P < 0.0020); both models also gave greater mean weighted coefficients of determination than deterministic compartment models. These results suggest that gamma-distributed residence time and fractal models better describe tracer clearance than deterministic compartment models and therefore should allow more accurate estimation of GFR.

Original languageEnglish
Pages (from-to)183-192
Number of pages10
JournalPhysiological Measurement
Volume31
Issue number2
DOIs
Publication statusPublished - 4 Feb 2010
Externally publishedYes

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Pediatrics
Glomerular Filtration Rate
Fractals
Pharmacokinetics
Plasmas
Kidney
Datasets
Neoplasms
Tumors

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abstract = "The glomerular filtration rate (GFR) is used clinically to assess renal function. The most accurate estimation technique is tracer clearance where deterministic compartment pharmacokinetic models are most widely used. The aim of this study was to assess the viability of alternative pharmacokinetic models to describe tracer clearance, and in turn, measure GFR. This study was carried out on 126 clearance datasets obtained from 44 patients with large solid tumours; these were fitted to four pharmacokinetic models with superiority of model determined by Akaike Information Criteria. A fractal model was found to be superior to the best deterministic compartment model (70{\%} of datasets, P < 0.0020) as was a gamma-distributed residence time model (93{\%} of datasets, P < 0.0020); both models also gave greater mean weighted coefficients of determination than deterministic compartment models. These results suggest that gamma-distributed residence time and fractal models better describe tracer clearance than deterministic compartment models and therefore should allow more accurate estimation of GFR.",
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The Effect of Improved Modelling of Plasma Clearance in Paediatric Patients with Expanded Body Spaces on Estimation of the Glomerular Filtration Rate. / Evans, Claire; Perkinson, A. S.; Burniston, M. T.; Smye, S. W.

In: Physiological Measurement, Vol. 31, No. 2, 04.02.2010, p. 183-192.

Research output: Contribution to journalArticle

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