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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    • "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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    • "The generally accepted operational definition of CKD is kidney damage and the kidneys' inability to filter blood as measured by Glomerular Filtration Rate (GFR) [1]. The clinical CKD stages are then defined by plotting the estimated GFR (eGFR) [6] [7] as shown in Table 1. "
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