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Clearance glomerular filtration rate

Yutaka Yonezawa, Shigeo Horinaka, Chiaki Shirakawa, Yoshio Kogure
Direct oral anti-coagulants (DOACs) have been used in patients with non-valvular atrial fibrillation (AF), and renal function evaluation using the CCr (Cockcroft-Gault) is recommended as a criterion for the reduction of DOAC. In contrast, estimated glomerular filtration rate (eGFR) is usually used as an index of renal function in daily practice. We determined the age- and gender-specific prevalence rates of AF and whether CCr or eGFR was associated with the prevalence of AF. Data from the periodic health examinations of 108,951 subjects were collected...
March 20, 2018: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Takamitsu Inoue, Jun Miyazaki, Daishi Ichioka, Shintaro Narita, Susumu Kageyama, Mikio Sugimoto, Koji Mitsuzuka, Yusuke Shiraishi, Hidefumi Kinoshita, Hironobu Wakeda, Takeshi Nomoto, Eiji Kikuchi, Yoshiyuki Matsui, Keiko Fujie, Tomonori Habuchi, Hiroyuki Nishiyama
BACKGROUND: To compare the prevalence of nephrotoxicity between patients with a solitary-functioning kidney versus those with bilateral-functioning kidneys during the administration of cisplatin-based chemotherapy for advanced urothelial carcinoma. METHODS: We retrospectively analyzed 244 advanced urothelial carcinoma patients treated with cisplatin-based chemotherapy between 2004 and 2010 at 17 institutes in Japan. The 24 h creatinine clearance, Cockcroft-Gault formula, and estimated glomerular filtration rate equation (eGFR), were compared before all chemotherapies...
March 14, 2018: BMC Cancer
Cathrin L Salvador, Anders Hartmann, Anders Åsberg, Stein Bergan, Alexander D Rowe, Lars Mørkrid
Background: Assessment of glomerular filtration rate (GFR) is important in kidney transplantation. The aim was to develop a kidney transplant specific equation for estimating GFR and evaluate against published equations commonly used for GFR estimation in these patients. Methods: Adult kidney recipients (n = 594) were included, and blood samples were collected 10 weeks posttransplant. GFR was measured by51 Cr-ethylenediaminetetraacetic acid clearance. Patients were randomized into a reference group (n = 297) to generate a new equation and a test group (n = 297) for comparing it with 7 alternative equations...
December 2017: Transplantation Direct
Amihai Rottenstreich, Netanel Zacks, Geffen Kleinstern, Bruria Hirsh Raccah, Batia Roth, Nael Da'as, Yosef Kalish
The role of drug-level monitoring among patients using direct-acting oral anticoagulant (DOAC) is unclear. We aimed to investigate its 'real-life' utilization and effect on clinical management. A review of records of patients who underwent DOAC level testing during 2013-2017. Overall, 212 patients (median age 77 years) underwent 292 DOAC measurements [apixaban (n = 147), rivaroxaban (n = 102), dabigatran (n = 43)]. Monitoring volume increased by 460% during study period. DOAC level testing was performed during routine follow-up in 51 (17...
March 12, 2018: Journal of Thrombosis and Thrombolysis
Lynn McBain, Anna Kyle
AIM: To assess annual renal function monitoring and clinical indications for use in patients prescribed dabigatran. METHOD: A quality improvement activity included all patients in the Compass Health Primary Health Organisation (PHO) prescribed dabigatran. Information recorded: demographics; indication for use; daily dose; height; weight; serum creatinine; and estimated glomerular filtration rate (eGFR). The first audit occurred during July 2013 - May 2014, the second during May 2014 - October 2016...
March 9, 2018: New Zealand Medical Journal
Jenny Skytte Larsson, Vitus Krumbholz, Anders Enskog, Gudrun Bragadottir, Bengt Redfors, Sven-Erik Ricksten
OBJECTIVE: Data on renal hemodynamics, function, and oxygenation in early clinical septic shock are lacking. We therefore measured renal blood flow, glomerular filtration rate, renal oxygen consumption, and oxygenation in patients with early septic shock. DESIGN: Prospective comparative study. SETTING: General and cardiothoracic ICUs. PATIENTS: Patients with norepinephrine-dependent early septic shock (n = 8) were studied within 24 hours after arrival in the ICU and compared with postcardiac surgery patients without acute kidney injury (comparator group, n = 58)...
March 6, 2018: Critical Care Medicine
Zohreh Naji Ebrahimi Yazd, Sara Hosseinian, Mohammad Naser Shafei, Alireza Ebrahimzadeh Bideskan, Nazanin Entezari Heravi, Soghra Parhizgar, Samira Shahraki, Zahra Samadi Noshahr, Somayeh Mahzari, Abolfazl Khajavi Rad
INTRODUCTION: Nephropathy is an important side effect of doxorubicin. The aim of the current study was to investigate the protective effect of Plantago major extract against doxorubicin-induced functional and histological damage in rat's kidney. MATERIALS AND METHODS: Sixty Albino rats were randomly divided into 6 groups. Doxorubicin, 5 mg/kg, was injected intravenously on the 7th day of the study. Animals were treated with dexamethasone, 0.9 mg/kg, vitamin E, 100 mg/kg, and P major extract, 600 mg/kg and 1200 mg/kg, for 7 days before and 4 weeks after doxorubicin administration...
March 2018: Iranian Journal of Kidney Diseases
Niels J Aachmann-Andersen, Soren J Christensen, Kristian Lisbjerg, Peter Oturai, Pär I Johansson, Niels-Henrik Holstein-Rathlou, Niels V Olsen
The effect of recombinant erythropoietin (rhEPO) on renal and systemic hemodynamics was evaluated in a randomized double-blinded, cross-over study. Sixteen healthy subjects were tested with placebo, or low-dose rhEPO for 2 weeks, or high-dose rhEPO for 3 days. Subjects refrained from excessive salt intake, according to instructions from a dietitian. Renal clearance studies were done for measurements of renal plasma flow, glomerular filtration rate (GFR) and the segmentel tubular handling of sodium and water (lithium clearance)...
March 2018: Physiological Reports
Jesse C Seegmiller, John H Eckfeldt, John C Lieske
The assessment of kidney function is a cornerstone in the clinical management and health of the patient. Although the kidneys perform many physiologic functions and are essential for maintaining homeostasis, kidney function is typically evaluated, quantitated, and understood using the glomerular filtration rate (GFR). Although GFR can be directly measured using a variety of externally administered glomerular filtration markers, in general practice, the GFR is usually estimated (eGFR) using endogenous markers that are cleared primarily by kidney filtration...
January 2018: Advances in Chronic Kidney Disease
Petter Bjornstad, Amy B Karger, David M Maahs
Accurate determination of glomerular filtration rate (GFR) is crucial for the diagnosis of kidney disease. Estimated GFR (eGFR) calculated by serum creatinine and/or cystatin C is a mainstay in clinical practice and epidemiologic research but lacks precision and accuracy until GFR <60 mL/min/1.73 m2 . Furthermore, eGFR may not precisely and accurately represent changes in GFR longitudinally. The lack of precision and accuracy is of concern in populations at high risk for kidney disease, as the dissociation between changes in eGFR and GFR may lead to missed diagnoses of early kidney disease...
January 2018: Advances in Chronic Kidney Disease
Lesley A Inker, Andrew S Levey, Josef Coresh
The recent Kidney Disease Improving Global Outcomes 2012 CKD guidelines recommend estimating GFR from serum creatinine (eGFRcr ) as a first-line test to assess kidney function and using cystatin C or measured glomerular filtration rate (GFR) as confirmatory tests. eGFRcr may be inaccurate in people with variation in muscle mass or diet, and eGFRcys is not more accurate than eGFRcr. eGFRcrcys is more accurate than either, but it is not independent of eGFRcr . Measured GFR is not practical and is susceptible to error due to variation in clearance methods and in the behavior of exogenous filtration markers...
January 2018: Advances in Chronic Kidney Disease
Verônica Torres da Costa E Silva, Elerson C Costalonga, Fernanda O Coelho, Renato A Caires, Emmanuel A Burdmann
Cancer patients are living longer. The sequelae of cancer treatment and the role of comorbid conditions present before the diagnosis, such as CKD, have been increasingly recognized. The interface between CKD and cancer is multifaceted. CKD is frequently observed in patients with cancer, and cancer treatment contributes to CKD development and progression. In addition, CKD has been recognized as an important risk factor for cancer development and reduced specific cancer survival. In this context, an accurate evaluation of the glomerular filtration rate (GFR) during oncologic treatment is pivotal and is used to define surgery strategies, program prophylactic management of contrasted examinations, make decisions on cisplatin eligibility, and adjust drug prescriptions, particularly chemotherapy agents...
January 2018: Advances in Chronic Kidney Disease
Joanna Q Hudson, Thomas D Nolin
Creatinine clearance has been the most common method of estimating kidney function for the purpose of drug dosing for decades. The availability and extensive clinical use of estimated glomerular filtration rate (eGFR) now provides clinicians a potential alternative. Currently, data demonstrating the validity of eGFR-based drug dosing is limited, but proof of principle has been established and the tide related to use of eGFR for drug dosing appears to be turning. Use of the same kidney function estimate for management of kidney disease, drug development and dosing, and harmonization in all clinical arenas would be ideal...
January 2018: Advances in Chronic Kidney Disease
Sheldon Chen
When the [creatinine] is changing, the kidney function can still be tracked with a quantitative technique called kinetic glomerular filtration rate (GFR). The equation yields useful information on the severity of acute kidney injury, the clinical course of kidney and dialysis clearances, and the timing of kidney recovery. It has been validated in at least 3 independent studies, where it performed sufficiently well in intensive care unit and kidney transplant settings, and in head-to-head comparisons with biomarkers...
January 2018: Advances in Chronic Kidney Disease
Justine B Bukabau, Ernest K Sumaili, Etienne Cavalier, Hans Pottel, Bejos Kifakiou, Aliocha Nkodila, Jean Robert R Makulo, Vieux M Mokoli, Chantal V Zinga, Augustin L Longo, Yannick M Engole, Yannick M Nlandu, François B Lepira, Nazaire M Nseka, Jean Marie Krzesinski, Pierre Delanaye
CONTEXT AND OBJECTIVE: In the estimation of glomerular filtration rate (GFR), ethnicity is an important determinant. However, all existing equations have been built solely from Caucasian and Afro-American populations and they are potentially inaccurate for estimating GFR in African populations. We therefore evaluated the performance of different estimated GFR (eGFR) equations in predicting measured GFR (mGFR). METHODS: In a cross-sectional study, 93 healthy adults were randomly selected in the general population of Kinshasa, Democratic Republic of the Congo, between June 2015 and April 2016...
2018: PloS One
Osamu Uemura, Naoyuki Iwata, Takuhito Nagai, Satoshi Yamakawa, Satoshi Hibino, Masaki Yamamoto, Masaru Nakano, Kazuki Tanaka
To determine the optimal method of evaluating kidney function in patients with thyroid dysfunction, this study compared the estimated glomerular filtration rate derived from serum creatinine, cystatin C, or β2-microglobulin with inulin or creatinine clearance in two pediatric patients, one with hypothyroidism and the other with hyperthyroidism. It was observed that the kidney function decreased in a hypothyroid child and enhanced in a hyperthyroid child, with their kidney function becoming normalized by treatment with drugs, which normalized their thyroid function...
February 28, 2018: CEN Case Reports
Kristin E Follman, Marilyn E Morris
Renal Impairment (RI) is a major health concern with a growing prevalence. RI leads to various physiological changes, in addition to a decrease in GFR, that impact the pharmacokinetics (PK) and specifically the renal clearance (CLR) of compounds, including alterations of drug transporter (DT)/drug metabolizing enzyme expression and activity, as well as protein binding. The objectives of this study were to utilize the physiologically based pharmacokinetic (PBPK) modeling platform, Simcyp® to (1) assess the impact of alterations in DT expression, toxin-drug interactions (TDIs) and free fraction (fu) on PK predictions for the OCT2/MATE1 substrate metformin in RI populations, and (2) utilize available in vitro data to improve predictions of ClR for two actively secreted substrates, metformin and ranitidine...
February 28, 2018: Drug Metabolism and Disposition: the Biological Fate of Chemicals
Seçil Conkar, Sevgi Mir, Fatma Nur Karaslan, Gülden Hakverdi
BACKGROUND: Glomerular filtration rate (GFR) is the best marker used to assess renal function. Estimated GFR (eGFR) equations have been developed, and the ideal formula is still under discussion. We wanted to find the most practical and reliable GFR in eGFR formulas. We compared serum creatinine (Scr)- and cystatin C (cysC)-based eGFR formulas in the literature. We also aimed to determine the suitability and the reliability of cysC for practical use in determining GFR in children. METHODS: We have enrolled 238 children in the study...
February 27, 2018: Journal of Clinical Laboratory Analysis
Marco van Londen, Anthony B Wijninga, Jannieta de Vries, Jan-Stephan F Sanders, Margriet F C de Jong, Robert A Pol, Stefan P Berger, Gerjan Navis, Martin H de Borst
Background: Living kidney donor safety requires reliable long-term follow-up of renal function after donation. The current study aimed to define the precision and accuracy of post-donation estimated glomerular filtration rate (eGFR) slopes compared with measured GFR (mGFR) slopes. Methods: In 349 donors (age 51 ± 10, 54% female), we analysed eGFR according to the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault/body surface area (CG/BSA), creatinine clearance (CrCl) and mGFR (125I-iothalamate) changes from 3 months until 5 years post-donation...
February 22, 2018: Nephrology, Dialysis, Transplantation
Qi Huang, Yunshuang Chen, Min Zhang, Sihe Wang, Weiguang Zhang, Guangyan Cai, Xiangmei Chen, Xuefeng Sun
PURPOSE: We compared the performance of technetium-99m-diethylenetriaminepentaacetic acid (99m Tc-DTPA) renal dynamic imaging (RDI), the MDRD equation, and the CKD EPI equation to estimate glomerular filtration rate (GFR). METHODS: A total of 551 subjects, including CKD patients and healthy individuals, were enrolled in this study. Dual plasma sample clearance method of99m Tc-DTPA was used as the true value for GFR (tGFR). RDI and the MDRD and CKD EPI equations for estimating GFR were compared and evaluated...
February 20, 2018: International Urology and Nephrology
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