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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter

IMPACT FACTOR 2018: 3.638

CiteScore 2018: 2.44

SCImago Journal Rank (SJR) 2018: 1.191
Source Normalized Impact per Paper (SNIP) 2018: 1.205

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Volume 57, Issue 7


Accuracy of determination of the glomerular filtration marker iohexol by European laboratories as monitored by external quality assessment

Gunnar Nordin / Sara Ekvall / Carolina Kristoffersson / Ann-Sofie Jonsson / Sten-Erik Bäck / Niclas Rollborn
  • Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University, Uppsala, Sweden
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/ Anders Larsson
  • Corresponding author
  • Department of Medical Sciences, Section of Clinical Chemistry, Uppsala University, Akademiska Sjukhuset, Entrance 61, 3rd Floor, Uppsala SE-75185, Sweden, Phone: +46 18 611 00 00, Fax: +46 18 611 37 03
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Published Online: 2019-05-10 | DOI: https://doi.org/10.1515/cclm-2018-1175



Glomerular filtration is the most important kidney function. The most accurate glomerular filtration rate (GFR) estimates are based on the clearance of exogenous filtration markers. Of these, iohexol is the only exogenous marker that is included in an external quality assessment (EQA) scheme. The aim of the present study was to evaluate the performance of the European laboratories participating in Equalis’ EQA scheme for iohexol.


Weighed amounts of iohexol (Omnipaque) were added to plasma samples and distributed to laboratories participating in the EQA scheme for iohexol. All laboratories performed the assays in a blinded fashion.


The number of participating laboratories varied between 27 and 34 during the study period. Iohexol was determined by HPLC in 77% of the laboratories and by UPLC/MS/MS methods in 15% of the laboratories. The mean interlaboratory coefficient of variation was 4.7% for the HPLC methods and 6.4% for the UPLC/MS/MS methods. The mean bias between calculated and measured iohexol values was –1.3 mg/L (95% confidence interval ±0.3) during the first part of the study period and 0.1 mg/L (±0.3) during the later part.


The low interlaboratory variation demonstrates that iohexol can be measured reliably by many laboratories and supports the use of iohexol as a GFR marker when there is a need for high quality GFR measurements.

Keywords: external quality assessment scheme; GFR; glomerular filtration rate; iohexol


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About the article

Received: 2018-11-01

Accepted: 2019-01-17

Published Online: 2019-05-10

Published in Print: 2019-06-26

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: The Uppsala University Hospital Research Fund, Sweden supported this study.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 7, Pages 1006–1011, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2018-1175.

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