{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:56:15Z","timestamp":1790560575146,"version":"4.1.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008800","name":"French Intensive Care Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008800","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Firalis SAS"},{"name":"Association pour la promotion \u00e0 Tours de la r\u00e9animation m\u00e9dicale"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the intensive care of critically ill patients, accurate and reliable determination of the glomerular filtration rate (GFR) is of utmost importance. We have previously used one of the most established methods for this purpose, iohexol plasma clearance measurement, in combination with a mechanistic model based on mass balances and physiological intercompartmental transport. Here, we apply this method in an intensive care unit setting to investigate its validity for estimating GFR and to interpret data from critically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In 86 patients undergoing advanced supportive care for shock, sepsis, or other severe conditions, GFR was estimated using the clearance of iohexol during 24\u2005h after an intravenous injection. Individual iohexol plasma clearance was determined by the mass balance model. Parameters were fitted to each patient\u2019s plasma clearance profiles to estimate GFR. The model estimates were compared with estimations using the established Br\u00f6chner\u2013Mortensen regression approach and a maximum a posteriori Bayesian estimator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Iohexol plasma disappearance was stable over the 24-h monitoring period in 80% of patients, while 20% exhibited unstable elimination profiles. In patients with stable profiles, the mechanistic model showed significant correlations with Br\u00f6chner\u2013Mortensen estimates and the Bayesian estimator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This physiology-based model strengthens the determination of GFR by providing interpretable parameters linked to transport and exchange processes between plasma and extracellular volumes and urinary excretion. The model shows that short-term GFR changes can be illustrated during the plasma concentration trajectory of iohexol, and short-term GFRs can be calculated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jalm\/jfag151","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:15:57Z","timestamp":1788520557000},"source":"Crossref","is-referenced-by-count":0,"title":["Monitoring of Intensive Care Patients by a Physiology-Related GFR Method"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4056-3751","authenticated-orcid":false,"given":"Bertil","family":"K\u00e5gedal","sequence":"first","affiliation":[{"name":"Department of Clinical Chemistry and Department of Biomedical and Clinical Sciences, Link\u00f6ping University , Link\u00f6ping ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1695-0695","authenticated-orcid":false,"given":"Jean-Baptiste","family":"Woillard","sequence":"additional","affiliation":[{"name":"Inserm U1248 P&T, University of Limoges , Limoges ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-4467","authenticated-orcid":false,"given":"Stephan","family":"Ehrmann","sequence":"additional","affiliation":[{"name":"M\u00e9decin Intensive R\u00e9animation, CIC 1415, CRICS-TriggerSEP F-CRIN Research Network, Tours University Hospital , Tours ,","place":["France"]},{"name":"Centre d'\u00e9tude des Pathologies Respiratoires, INSERM U1100, Universit\u00e9 de Tours , Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7675-9564","authenticated-orcid":false,"given":"Charlotte","family":"Salmon-Gandonni\u00e8re","sequence":"additional","affiliation":[{"name":"M\u00e9decin Intensive R\u00e9animation, CIC 1415, CRICS-TriggerSEP F-CRIN Research Network, Tours University Hospital , Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8563-8801","authenticated-orcid":false,"given":"Isabelle","family":"Benz-de Bretagne","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Tours University Hospital and INSERM, Imaging Brain & Neuropsychiatry iBraiN U1253, Tours University , Tours ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9711-794X","authenticated-orcid":false,"given":"Carl-Fredrik","family":"Mandenius","sequence":"additional","affiliation":[{"name":"Department of Physics, Chemistry and Biology, Link\u00f6ping University , Link\u00f6ping ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"2026092721275443000_jfag151-B1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1038\/s41581-019-0191-y","article-title":"Measured and estimated glomerular filtration rate: current status and future directions","volume":"16","author":"Levey","year":"2020","journal-title":"Nat Rev Nephrol"},{"key":"2026092721275443000_jfag151-B2","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1053\/j.ajkd.2021.04.016","article-title":"Measurement and estimation of GFR for use in clinical 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