Measuring the glomerular filtration rate in obese individuals without overt kidney disease

Allon Friedman, Matthew Strother, Sara Quinney, Stephen Hall, Susan Perkins, Edward J. Brizendine, Margaret Inman, Gerardo Gomez, Zak Shihabi, Sharon Moe, Lang Li

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Identifying methods to accurately measure the glomerular filtration rate (GFR) in obese individuals without kidney overt kidney disease is necessary to understanding the pathophysiology and natural history of obesity-related kidney disease. Methods: Using a cross-sectional design, iohexol clearance and disposition was measured, an optimal sampling schedule was identified, and the reliability of GFR-estimating methods was described in 29 obese individuals with normal serum creatinine levels. Iohexol disposition was measured using population pharmacokinetics. The agreement with GFR-estimating equations was assessed by intraclass coefficients. Results: Mean age was 44 ± 10 years, body mass index 45 ± 10, creatinine 0.7 ± 0.2 mg/dl (62 ± 18 μmol/l) , and cystatin C 0.83 ± 0.18 mg/dl (8.3 ± 1.8 mg/l). Iohexol disposition fit a two-compartment model and 5 sampling windows were identified over a 4-hour period to optimize model accuracy and minimize blood draws. Precision was not compromised with this sampling design. Neither creatinine nor cystatin C were linearly correlated with the measured GFR though cystatin C was independent of body composition. Agreement was fair to poor between the measured GFR and GFR-estimating equations. Conclusion: This study offers a rigorous method to study obesity-related kidney disease and improve upon suboptimal GFR-estimating methods.

Original languageEnglish
JournalNephron - Clinical Practice
Volume116
Issue number3
DOIs
StatePublished - Oct 2010

Fingerprint

Kidney Diseases
Glomerular Filtration Rate
Iohexol
Cystatin C
Creatinine
Obesity
Body Composition
Appointments and Schedules
Body Mass Index
Pharmacokinetics
Kidney
Serum
Population

Keywords

  • Creatinine
  • Cystatin C
  • Glomerular filtration rate
  • Iohexol
  • Obesity

ASJC Scopus subject areas

  • Nephrology

Cite this

Measuring the glomerular filtration rate in obese individuals without overt kidney disease. / Friedman, Allon; Strother, Matthew; Quinney, Sara; Hall, Stephen; Perkins, Susan; Brizendine, Edward J.; Inman, Margaret; Gomez, Gerardo; Shihabi, Zak; Moe, Sharon; Li, Lang.

In: Nephron - Clinical Practice, Vol. 116, No. 3, 10.2010.

Research output: Contribution to journalArticle

Friedman, Allon ; Strother, Matthew ; Quinney, Sara ; Hall, Stephen ; Perkins, Susan ; Brizendine, Edward J. ; Inman, Margaret ; Gomez, Gerardo ; Shihabi, Zak ; Moe, Sharon ; Li, Lang. / Measuring the glomerular filtration rate in obese individuals without overt kidney disease. In: Nephron - Clinical Practice. 2010 ; Vol. 116, No. 3.
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