Assessing Kidney Function — Measured and Estimated Glomerular Filtration Rate

Johns Hopkins Medicine, Baltimore, Maryland, United States
New England Journal of Medicine (Impact Factor: 55.87). 07/2006; 354(23):2473-83. DOI: 10.1056/NEJMra054415
Source: PubMed


In the coming years, estimates of the glomerular filtration rate (GFR) may replace the measurement of serum creatinine as the primary tool for the assessment of kidney function. Indeed, many clinical laboratories already report estimated GFR values whenever serum creatinine is measured. This review considers current methods of measuring GFR and GFR-estimating equations and their strengths and weaknesses as applied to chronic kidney disease.

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    • "Based on serum creatinine, Cockcroft-Gault formula and modification of diet in renal disease (MDRD) equations are of limited value in cirrhotic patients; they overestimate the GFR as well [7]. Serum cystatin C (CysC) has been proposed as a novel biomarker of the renal function [8]. Several studies have reported its value in different sets of patients [9] [10] [11] [12] [13] [14] [15] [16]. "
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    ABSTRACT: Serum cystatin C (CysC) was proposed as an effective reflection of the glomerular filtration rate (GFR). However, its role in patients with liver cirrhosis has not been extensively verified especially in the detection of early RI. Patients and Methods. Seventy consecutive potential candidates for living donor liver transplantation with serum creatinine (Cr)
    10/2015; 2015(8). DOI:10.1155/2015/309042
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    • "Although the MDRD study equation has generally been used for estimating GFR and evaluating CKD, imprecision and underestimation of GFR have been reported as major limitations, especially in those with early stage of CKD (GFR ≥ 60 mL/min/1.73 m 2 ) [1] [11] [12]. In addition, in diabetic patients with microalbuminuria or overt diabetic nephropathy, it was reported that the MDRD Study equation significantly underestimated GFR [17]. "
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    • "Nephropathy was defined as the presence of eGFR b 60 ml/min/1.73 m 2 and/or abnormal albuminuria (i.e., an albumin-to-creatinine ratio ≥30 mg/g creatinine) (Stevens et al., 2006). Presence of internal or common carotid artery stenoses was also ascertained by echo-Doppler scanning in all participants. "
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    ABSTRACT: We assessed whether left atrial volume index (LAVI) was associated with the presence of microvascular complications in patients with type 2 diabetes, and whether this association was independent of hemodynamic and non-hemodynamic factors. We studied 157 consecutive outpatients with type 2 diabetes with no previous history of ischemic heart disease, chronic heart failure and valvular diseases. A transthoracic echocardiography and myocardial perfusion scintigraphy were performed in all participants. Presence of microvascular complications was also recorded. Overall, 51 patients had decreased estimated glomerular filtration rate and/or abnormal albuminuria, 24 had diabetic retinopathy, 22 had lower-extremity sensory neuropathy, and 67 (42.7%) patients had one or more of these microvascular complications (i.e., combined endpoint). After stratifying patients by LAVI, those with LAVI ≥32ml/m(2) had a greater prevalence of microvascular complication, lower left ventricular (LV) ejection fraction, higher LV mass index and higher E/e' ratio than those with LAVI <32ml/m(2). Logistic regression analyses revealed that microvascular complications (singly or in combination) were associated with increased LAVI, independently of age, sex, diabetes duration, hemoglobin A1c, hypertension, LV-ejection fraction, LV mass index and the E/e' ratio. These results indicate that microvascular diabetic complications are associated with increased LAVI in well-controlled type 2 diabetic patients with preserved systolic function and free from ischemic heart disease, independently of multiple potential confounders. Copyright © 2015. Published by Elsevier Inc.
    Journal of Diabetes and its Complications 05/2015; 29(6). DOI:10.1016/j.jdiacomp.2015.05.006 · 3.01 Impact Factor
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