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Article Review/Hyperlink
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Swan Sk, Nalstenson CE, Kasiske BL, Collins AJ
Determination of residual renal function with iohexol
clearance in hemodialysis patients
Kidney Int
(Jan) 49:232-235 1996

Residual renal function (RRF) may contribute substantially to the
total clearance of waste products in dialysis patients and should
be considered when using Kt/V for establishing a dialysis
prescription. The need for 24-urine collections or the use of
markers that require special handling, such as, radioactive
materials complicates the measurement of RRF. Iohexol clearance
has been shown to be a marker of the glomerular filtration rate
in patients with normal and impaired renal function.
Investigators from Minneapolis used the iohexol clearance to
estimate RRF in hemodialysis patients and compared iohexol
clearance to urea clearance. They gave an intravenous bolus of
iohexol to 42 hemodialysis patients through their venous return
lines at the end of a dialysis treatment. Just before the next
dialysis treatment, 44 hours later, they obtained a single blood
sample for the measurement of iohexol plasma concentration.
Iohexol-derived RRF did not differ from urea-derived RRF. The
RRF contribution to the weekly dialysis prescription, Kt/V, did
not differ when they compared iohexol-derived RRF with urea
derived RRF.
Comment: This study shows that the single point
determination of iohexol clearance is an accurate measure of RRF
in HD patients and may simplify the measurement of RRF in
hemodialysis patients. This technique seems safe, accurate, and
is convenient, in that it requires a single blood test and no
urine collection. (George R. Aronoff, M.D.)
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