Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate

Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in...

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Main Authors: Kjellbjørn Jakobsen, Bjørn O. Eriksen, Ole M. Fuskevåg, Stephen J. Hodges, Lars M. Ytrebø
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Nephrology
Online Access:http://dx.doi.org/10.1155/2022/8267829
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author Kjellbjørn Jakobsen
Bjørn O. Eriksen
Ole M. Fuskevåg
Stephen J. Hodges
Lars M. Ytrebø
author_facet Kjellbjørn Jakobsen
Bjørn O. Eriksen
Ole M. Fuskevåg
Stephen J. Hodges
Lars M. Ytrebø
author_sort Kjellbjørn Jakobsen
collection DOAJ
description Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.
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spelling doaj-art-706f6c05cc2d470bb63c98b528b4305e2025-08-20T02:06:47ZengWileyInternational Journal of Nephrology2090-21582022-01-01202210.1155/2022/8267829Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration RateKjellbjørn Jakobsen0Bjørn O. Eriksen1Ole M. Fuskevåg2Stephen J. Hodges3Lars M. Ytrebø4Anesthesia and Critical Care Research GroupMetabolic and Renal Research GroupDepartment of Laboratory MedicineAnesthesia and Critical Care Research GroupAnesthesia and Critical Care Research GroupContinuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.http://dx.doi.org/10.1155/2022/8267829
spellingShingle Kjellbjørn Jakobsen
Bjørn O. Eriksen
Ole M. Fuskevåg
Stephen J. Hodges
Lars M. Ytrebø
Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate
International Journal of Nephrology
title Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate
title_full Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate
title_fullStr Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate
title_full_unstemmed Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate
title_short Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate
title_sort continuous infusion of iohexol to monitor perioperative glomerular filtration rate
url http://dx.doi.org/10.1155/2022/8267829
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