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Measure GFR

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
W Greg Miller, Graham R D Jones
In 2002, the Kidney Disease Outcomes Quality Initiative guidelines for identifying and treating CKD recommended that clinical laboratories report estimated glomerular filtration rate (eGFR) with every creatinine result to assist clinical practitioners to identify people with early-stage CKD. At that time, the original Modification of Diet in Renal Disease (MDRD) Study equation based on serum creatinine measurements was recommended for calculating eGFR. Because the MDRD Study equation was developed using a nonstandardized creatinine method, a Laboratory Working Group of the National Kidney Disease Education program was formed and implemented standardized calibration traceability for all creatinine methods from global manufacturers by approximately 2010...
January 2018: Advances in Chronic Kidney Disease
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
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
Kristian Heldal, Karsten Midtvedt, Anders Hartmann, Anna Varberg Reisaeter, Torbjørn Fossum Heldal, Stein Bergan, Cathrin Lytomt Salvador, Anders Åsberg
Several equations have been developed for estimated glomerular filtration rate (eGFR) in patients with chronic kidney disease (CKD), but none were developed based on data from elderly kidney transplant recipients (KTR). The primary aim of this study was to evaluate different creatinine based equations in stable elderly KTR. A national cross-sectional study was performed using data from 263 consecutive kidney transplant recipients 60 years or older who performed a routine GFR measurement one year after engraftment...
February 17, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Andrea Corsonello, Claudio Pedone, Stefania Bandinelli, Luigi Ferrucci, Raffaele Antonelli Incalzi
AIMS: There is uncertainty about which estimated glomerular filtration rate eGFR equation to use in older people with respect to the prediction of prognosis. Our aim was: (i) to compare the discriminative capacity of eGFR estimated by different equations with respect to all-cause mortality; and (ii) to identify the eGFR threshold at which the risk of mortality starts to increase for each equation. METHODS: We used data from 828 community-dwelling older adults aged >65 years enrolled in the InCHIANTI study...
January 22, 2018: Geriatrics & Gerontology International
Laura A Hart, Gail D Anderson
International guidelines recommend the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method to monitor kidney function in chronic kidney disease using either creatinine- or cystatin C-based estimation methods. The choice of an estimation method to determine dosage for renally eliminated drugs is not as clear. For the majority of currently marketed drugs, the Cockcroft-Gault equation with the Jaffe method, a non-isotope dilution mass spectrometry, standardized serum creatinine, was used to estimate kidney function to recommend dosing adjustment in kidney impairment...
January 22, 2018: Clinical Pharmacokinetics
Mário B G Nunes, Antônio C Filho, Valéria R C Alvares, Rafael Moreno, Edgar Lamas, Vitor Loures, Daniel Chamié, Alexandre Abizaid
INTRODUCTION: Individuals with glomerular filtration rate (GFR) ≥60 ml/min/1.73 m2 estimated by the Cockcroft-Gault formula (CG) who undergo percutaneous coronary intervention (PCI) frequently develop contrast-induced nephropathy (CIN). This study aimed to assess whether individuals with significant renal impairment assessed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, but not by CG, more often develop CIN following PCI than those without renal impairment by either formula...
January 15, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Amy B Karger, Lesley A Inker, Josef Coresh, Andrew S Levey, John H Eckfeldt
Creatinine-based glomerular filtration rate estimation (eGFRcr ) has been improved and refined since the 1970s through both the Modification of Diet in Renal Disease (MDRD) Study equation in 1999 and the CKD Epidemiology Collaboration (CKD-EPI) equation in 2009, with current clinical practice dependent primarily on eGFR for accurate assessment of GFR. However, researchers and clinicians have recognized limitations of relying on creatinine as the only filtration marker, which can lead to inaccurate GFR estimates in certain populations due to the influence of non-GFR determinants of serum or plasma creatinine...
December 2017: EJIFCC
Laurence Piéroni, Anne-Sophie Bargnoux, Jean-Paul Cristol, Etienne Cavalier, Pierre Delanaye
During the last decade, a lot of efforts has been made to improve the evaluation of renal functions. Measured Glomerular Filtration Rate (GFR) remains the only valuable test to confirm or confute the status of chronic kidney disease (CKD) and is recommended by Kidney Disease Global Outcomes guidelines when estimation of GFR is not reliable. However, in routine clinical practice, serum creatinine remains the one of the most prescribed biological parameters and is an undeniable factor, alone or in association with other parameters, of the estimation of GFR...
December 2017: EJIFCC
Hans Pottel, Pierre Delanaye, Laurent Weekers, Luciano Selistre, Karolien Goffin, Olivier Gheysens, Laurence Dubourg
BACKGROUND: Defining mean and reference intervals for glomerular filtration rate (GFR) has been the subject of only a limited number of studies and review articles, with contradicting statements about the mean. Normal measured GFR (mGFR) values of ∼120-130 mL/min/1.73 m(2) have long been the referenced values for young adults but seem to be too high according to recent studies. Reference intervals are difficult to define because of the age decline of GFR, which is also observed in healthy subjects...
August 2017: Clinical Kidney Journal
U Huynh-Do, M Fiedler, B Vogt
Chronic renal insufficiency has a high prevalence and leads not only to a severe impairment in the quality of life but also to a higher mortality, mainly due to cardiovascular complications; however, in the early stages where there is still a chance for a therapeutic intervention, it is often underestimated because depending on endogenous factors (e.g. age and muscle mass), serum creatinine could falsely remain in the normal range while kidney function is already impaired. An exact measurement of the glomerular filtration rate (GFR) using radionuclide techniques is cumbersome and usually confined to rare cases, such as in clinical studies...
January 10, 2018: Der Internist
Pierre Delanaye, Martin Flamant, Laurence Dubourg, Emmanuelle Vidal-Petiot, Sandrine Lemoine, Etienne Cavalier, Elke Schaeffner, Natalie Ebert, Hans Pottel
Background: There are many different ways to measure glomerular filtration rate (GFR) using various exogenous filtration markers, each having their own strengths and limitations. However, not only the marker, but also the methodology may vary in many ways, including the use of urinary or plasma clearance, and, in the case of plasma clearance, the number of time points used to calculate the area under the concentration-time curve, ranging from only one (Jacobsson method) to eight (or more) blood samples...
January 8, 2018: Nephrology, Dialysis, Transplantation
Teodoro J Oscanoa, José P Amado, Roman Romero-Ortuno, José A Hidalgo
AIM: CKD-EPIcr (Chronic Kidney Disease Epidemiology Collaboration creatinine) and BIS1 (Berlin Initiative Study) are two serum creatinine-based formulae for the estimation of glomerular filtration rate (GFR). However, their comparative accuracy in older people has not been well established. Our aim was to conduct a systematic comparative study of the accuracy of estimation of GFR in older people with these two formulae. METHODS: We conducted a systematic search in Pubmed, EMBASE and Central databases on the validity of the CKD-EPIcr and BIS1 formulae in people aged 60 or more years...
March 2018: Archives of Gerontology and Geriatrics
Lingxiong Chai, Meifang Wang, Kedan Cai, Qun Luo, Haihong Yi, Jianyong Wu
OBJECTIVE: To assess the performance of the full age spectrum (FAS) equation in comparison to other equations in subjects with chronic kidney disease (CKD) for the first time in China. MATERIALS AND METHODS: The measured glomerular filtration rate (mGFR) obtained by the 99mTc-diethylenetriamine pentaacetic acid renogram was used as the reference standard. Bias, precision, and accuracy were analyzed to identify which of these four equations performed better: FAS equation, the Modification of Diet in Renal Disease (MDRD) equation, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and the Berlin Initiative Study-1 (BIS-1) equation...
December 18, 2017: Clinical Nephrology
Maisarah Jalalonmuhali, Soo Kun Lim, Mohammad Nazri Md Shah, Kok Peng Ng
BACKGROUND: Accurate measurement of renal function is important: however, radiolabelled gold standard measurement of GFR is highly expensive and can only be used on a very limited scale. We aim to compare the performance of Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations in the multi-ethnic population attending University Malaya Medical Centre (UMMC). METHODS: This is a cross-sectional study recruiting patients, who attend UMMC Nephrology clinics on voluntary basis...
December 13, 2017: BMC Nephrology
Sergio Luis-Lima, Flavio Gaspari, Natalia Negrín-Mena, Fabiola Carrara, Laura Díaz-Martín, Alejandro Jiménez-Sosa, Federico González-Rinne, Armando Torres, Esteban Porrini
Background: Renal function can be estimated with formulas, which are inaccurate, or measured with gold standard methods, which are reliable but unpractical. We propose to simplify the plasma clearance of iohexol, a gold standard method to measure renal function, by dried blood spot (DBS) testing. Methods: We compared glomerular filtration rate (GFR) values assessed by DBS and the reference plasma analysis technique. We tested in vitro the agreement between non-volumetric and volumetric DBS with the reference technique...
December 4, 2017: Nephrology, Dialysis, Transplantation
Helen Legrand, Karin Werner, Anders Christensson, Mats Pihlsgård, Sölve Elmståhl
BACKGROUND: Differences in cystatin C and creatinine-based estimated glomerular filtration rate (eGFR) can lead to clinical uncertainty. Existing eGFR equations perform poorly in a subset of individuals. This study aims to describe the prevalence of differences between cystatin C-based (eGFRcys ) and creatinine-based (eGFRcreat ) eGFR in older adults and to explore which subsets of individuals may be most affected by differing estimations. METHODS: In this cross-sectional study, participants from a cohort of community-dwelling older adults were examined at a baseline visit in 2001-2004 as part of the larger "Good Aging in Skåne" study...
December 4, 2017: BMC Nephrology
Pietro Trocchi, Matthias Girndt, Christa Scheidt-Nave, Silke Markau, Andreas Stang
BACKGROUND: Estimating equations are recommended by clinical guidelines as the preferred method for assessment of glomerular filtration rate (GFR). The aim of the study was to compare population-based prevalence estimates of decreased kidney function in Germany defined by an estimated GFR (eGFR) <60 ml/min/1.73m2 using different equations. METHODS: The study included 7001 participants of the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1) for whom GFR was estimated using the Modification of Diet in Renal Disease study equation (MDRD), the revised Lund-Malmö equation (LM), the Full Age Spectrum creatinine equation (FAScre), the Chronic Kidney Disease Epidemiology Collaboration equations with creatinine and cystatin C (CKD-EPIcrecys), with creatinine (CKD-EPIcre) and with cystatin C (CKD-EPIcys)...
November 28, 2017: BMC Nephrology
M Monlun, L Blanco, L Alexandre, K Mohammedi, V Rigalleau
No abstract text is available yet for this article.
February 2018: Diabetic Medicine: a Journal of the British Diabetic Association
John J Dixon, Katie Lane, R Neil Dalton, Charles Turner, Iain A M MacPhee, Irina Chis Ster, Barbara J Philips
OBJECTIVE: Measurement of changing glomerular filtration rate in acute kidney injury remains problematic. We have previously used a continuous infusion of low-dose Iohexol to measure glomerular filtration rate in stable subjects and postulate that changes greater than 10.3% in critically ill patients indicate acute kidney injury. Our objective is to explore the extent to which continuous infusion of low-dose Iohexol can be a measure of changing glomerular filtration rate during acute kidney injury...
March 2018: Critical Care Medicine
2017-12-03 14:14:18
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