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Measure GFR

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Elias David-Neto, Ana Heloisa Kamada Triboni, Fernanda Ramos, Fabiana Agena, Nelson Zocoler Galante, Marcelo Altona, Francine Brambate Carvalhinho Lemos, Marcelo Tatit Sapienza, William Carlos Nahas
Equations to estimate glomerular filtration rate (eGFR) were developed in patients using the variables: age, body weight and serum creatinine which may be different in the elderly. Elderly renal transplant patients (EG; n=70; mean age 65±4y) who measured plasma (51) Cr-EDTA-Clearance (mGFR) had mGFR compared to eGFR obtained by the Cockcroft-Gault corrected by body surface area (CG-BSA), the Modification of Diet in Renal Disease (MDRD-4), the Berlin Initiative Study (BIS-1) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)...
October 11, 2016: Clinical Transplantation
Pierre Delanaye, Toralf Melsom, Natalie Ebert, Sten-Erik Bäck, Christophe Mariat, Etienne Cavalier, Jonas Björk, Anders Christensson, Ulf Nyman, Esteban Porrini, Giuseppe Remuzzi, Piero Ruggenenti, Elke Schaeffner, Inga Soveri, Gunnar Sterner, Bjørn Odvar Eriksen, Flavio Gaspari
A reliable assessment of glomerular filtration rate (GFR) is of paramount importance in clinical practice as well as epidemiological and clinical research settings. It is recommended by Kidney Disease: Improving Global Outcomes guidelines in specific populations (anorectic, cirrhotic, obese, renal and non-renal transplant patients) where estimation equations are unreliable. Measured GFR is the only valuable test to confirm or confute the status of chronic kidney disease (CKD), to evaluate the slope of renal function decay over time, to assess the suitability of living kidney donors and for dosing of potentially toxic medication with a narrow therapeutic index...
October 2016: Clinical Kidney Journal
Xun Liu, Meredith C Foster, Hocine Tighiouart, Amanda H Anderson, Gerald J Beck, Gabriel Contreras, Josef Coresh, John H Eckfeldt, Harold I Feldman, Tom Greene, L Lee Hamm, Jiang He, Edward Horwitz, Julia Lewis, Ana C Ricardo, Haochang Shou, Raymond R Townsend, Matthew R Weir, Lesley A Inker, Andrew S Levey
BACKGROUND: Unlike the case with creatinine, conditions affecting the non-glomerular filtration rate (GFR) determinants of low-molecular-weight serum proteins, β-trace protein (BTP), β2-microglobulin (B2M), and cystatin C, are not well characterized. STUDY DESIGN: Pooled cross-sectional analysis of 3 studies. SETTING & PARTICIPANTS: 3,156 persons with chronic kidney disease from the MDRD (Modification of Diet in Renal Disease) Study, AASK (African American Study of Kidney Disease and Hypertension), and CRIC (Chronic Renal Insufficiency Cohort) Study...
September 20, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Swetha Pasala, J Bryan Carmody
Glomerular filtration rate (GFR) is the best overall measure of kidney function. The GFR is relatively low at birth but increases through infancy and early childhood to reach adult levels of approximately 120 mL/min/1.73 m(2) by age 2. While GFR can be measured most accurately by the urinary clearance of an exogenous ideal filtration marker such as inulin, it is more clinically useful to estimate GFR using a single serum measurement of an endogenous biomarker such as creatinine or cystatin C. When in steady state, there is an inverse relationship between creatinine/cystatin C and GFR, allowing GFR to be estimated from either using simple equations...
September 19, 2016: Archives of Disease in Childhood. Education and Practice Edition
Xuehan Zhang, Charles E McCulloch, Feng Lin, Yen-Chung Lin, Isabel Elaine Allen, Nisha Bansal, Alan S Go, Chi-Yuan Hsu
BACKGROUND AND OBJECTIVES: Overestimation of GFR by urinary creatinine clearance (CrCl) at lower levels of GFR has long been attributed to enhanced creatinine secretion. However, this does not take into consideration the contribution of errors in measured GFR (and CrCl) due to short-term biologic variability or test imprecision. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We analyzed cross-sectional data among 1342 participants from the Chronic Renal Insufficiency Cohort study with baseline measurement of GFR by iothalamate clearance (iGFR) and CrCl by 24-hour urine collection...
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Lan Wu, Vivian Yawei Guo, Carlos King Ho Wong, Kenny Kung, Li Han, XinLing Wang, Yunzhi Luo
BACKGROUND: Most of the existing risk scores for identifying people with reduced estimated glomerular filtration rate (eGFR) involve laboratory-based factors, which are not convenient and cost-effective to use in large population-based screening program. We aimed at using non-invasive variables to identify subjects with reduced eGFR in a Chinese working population. METHODS: Two study populations were recruited in 2012 and 2015, respectively. The 2012 study population (n = 14,374) was randomly separated as the training dataset (n = 9,621) or the internal testing dataset (n = 4,753) at a ratio of 2:1, and the 2015 study population (n = 4,371) was used as the external testing dataset...
September 14, 2016: Nephrology
Petter Bjornstad, Marko Škrtić, Yuliya Lytvyn, David M Maahs, Richard J Johnson, David Z I Cherney
Diabetic kidney disease (DKD) remains the leading cause of end-stage renal disease. A major challenge in preventing DKD is the difficulty in identifying high-risk patients at an early, pre-clinical stage. Albuminuria and eGFR as measures of renal function in DKD research and clinical practice are limited by regression of one-third of patients with microalbuminuria to normoalbuminuria and eGFR is biased and imprecise in the normal-elevated range. Moreover, existing methods that are used to assess renal function do not give detailed insight into the location of the renal hemodynamic effects of pharmacological agents at the segmental level...
September 7, 2016: American Journal of Physiology. Renal Physiology
Jiaguo Huang, Stefanie Weinfurter, Pedro Caetano Pinto, Marc Pretze, Bettina Kränzlin, Johannes Pill, Rodeghiero Federica, Rossana Perciaccante, Leopoldo Della Ciana, Rosalinde Masereeuw, Norbert Gretz
Evaluation of renal function is crucial for a number of clinical situations. Here, we reported a novel exogenous fluorescent marker (FITC-HPβCD) to real-time assess renal function by using a transcutaneous fluorescent detection technique. FITC-HPβCD was designed based on the principle of renal clearance of designed drugs. It displays favorable fluorescent properties, high hydrophilicity, low plasma protein binding, high stability in porcine liver esterase as well as in plasma and non-toxicity. More importantly, FITC-HPβCD can be efficiently and rapidly filtered by glomerulus and completely excreted into urine without proximal tubular reabsorption or secretion in rat models...
September 9, 2016: Bioconjugate Chemistry
S Avinash, V P Singh, A K Agarwal, S Chatterjee, V Arya
BACKGROUND: Cystatin C is a low molecular weight protein produced by all nucleated human cells, with a stable production rate. Its levels are not influenced by inflammation, infections, hepatic or renal diseases, or by dietary or constitutional factors. We compared serum cystatin C and serum creatinine based predicting equations to estimate glomerular filteration rate (GFR) in type 2 diabetes mellitus, using the staging of chronic kidney disease (CKD) defined by the National Kidney Foundation...
November 2015: Journal of the Association of Physicians of India
Elodie Cartet-Farnier, Laetitia Goutelle-Audibert, Pascal Maire, Blandine De la Gastine, Sylvain Goutelle
The objectives of this study were to compare the estimations of renal function obtained with six equations, including the Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations and to evaluate the implication of using other equations for drug dosing in elderly patients in place of CG. An observational prospective study was conducted over 6 months in two geriatric hospitals with inclusions of all hospitalized inpatients. A list of 36 drugs for which recommendations of dosage adjustment for renal function were mentioned in the manufacturer dosing guidelines was used to compare the implications of using the various equations for drug dosing...
September 7, 2016: Fundamental & Clinical Pharmacology
Michael V Rocco, Arlene Chapman, Glenn M Chertow, Debbie Cohen, Jing Chen, Jeffrey A Cutler, Matthew J Diamond, Barry I Freedman, Amret Hawfield, Eric Judd, Anthony A Killeen, Kent Kirchner, Cora E Lewis, Nicholas M Pajewski, Barry M Wall, Jerry Yee
BACKGROUND: Interventional trials have used either the Modification of Diet in Renal Disease (MDRD) or chronic kidney disease (CKD)-Epidemiology Collaboration (CKD-EPI) equation for determination of estimated glomerular filtration rate (eGFR) to define whether participants have stages 3-5 CKD. The equation used to calculate eGFR may influence the number and characteristics of participants designated as having CKD. METHODS: We examined the classification of CKD at baseline using both equations in the Systolic Blood Pressure Intervention Trial (SPRINT)...
2016: American Journal of Nephrology
Andrew D Rule, Walter K Kremers
No abstract text is available yet for this article.
September 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Ł Czyżewski, J Wyzgał, E Czyżewska, A Kurowski, J Sierdziński, A Łabuś, Z Truszewski, Ł Szarpak
BACKGROUND: Monitoring of the function of the implanted kidney in renal transplant recipients (RTRs) is one of the superior elements of adequate therapeutic actions. The aim of this study was to assess the conventional and unconventional factors affecting the estimated glomerular filtration rate (eGFR) with the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft-Gault (C-G) formulas among the RTRs. METHODS: The study included 144 RTRs (mean age 52 years)...
June 2016: Transplantation Proceedings
Joe M El-Khoury, Dustin R Bunch, Bo Hu, Drew Payto, Edmunds Z Reineks, Sihe Wang
OBJECTIVES: Symmetric dimethylarginine (SDMA) is a catabolic product of arginine-methylated proteins and is an emerging biomarker for kidney function. A limited number of studies in selected populations have shown good correlation between SDMA and a few known markers of glomerular filtration rate (GFR). However, a comprehensive comparison of SDMA with all existing serum endogenous markers in a population with varied kidney function and against measured GFR is lacking. The objective of this study was to compare the correlations of SDMA, creatinine, cystatin C and their eGFR equations against GFR measured by iothalamate clearance in an adult population with varied kidney function...
October 2016: Clinical Biochemistry
Priya Vart, Morgan E Grams
Assessment of kidney function is important for the detection and management of chronic kidney disease. The glomerular filtration rate (GFR) and level of albuminuria are two frequently used indices of kidney function assessment. Administration of an exogenous filtration marker to measure GFR and collection of urine for 24 hours to measure albumin excretion generally are considered the gold standard for GFR and albuminuria, respectively, but they are time consuming and onerous for the patient. Thus, in routine clinical practice, other methods are used more frequently to assess GFR and albuminuria...
July 2016: Seminars in Nephrology
Felix Kork, Felix Balzer, Alexander Krannich, Martin H Bernardi, Holger K Eltzschig, Joachim Jankowski, Claudia Spies
AIM: Acute kidney injury (AKI) is diagnosed by a 50% increase in creatinine. For patients without a baseline creatinine measurement, guidelines suggest estimating baseline creatinine by back-calculation. Aim of this study was to evaluate different GFR equations and different GFR assumptions for back-calculating baseline creatinine as well as the effect on the diagnosis of AKI. METHODS: The Modified MDRD, the Chronic Kidney Disease Epidemiology (CKD-EPI), and the Mayo Quadratic (MQ) equation were evaluated to estimate baseline creatinine, each under the assumption of either a fixed GFR of 75 mL/min/1...
July 27, 2016: Acta Physiologica
Guan Changjie, Zhu Xusheng, He Feng, Qin Shuguang, Li Jianwen, Fu Junzhou
PURPOSE: Performance of equations in elderly with chronic kidney disease (CKD) was debated. We aimed to access the performances of estimating equations for glomerular filtration rate in Chinese elderly population with chronic kidney disease. METHODS: Participants [N = 218, median age, 82 (range 75-96)] with CKD underwent renal dynamic imaging using technetium-99m diethylene-triamine-penta-acetic acid (99mTc-DTPA). The performances of glomerular filtration rate equations including the Cockcroft-Gault equation, the MDRD (Modification of Diet in Renal Disease) equation for Chinese, 3 CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equations, and 2 BIS (Berlin Initiative Study) equations were compared...
July 11, 2016: International Urology and Nephrology
Chava L Ramspek, Hakan Nacak, Merel van Diepen, Marjolijn van Buren, Raymond T Krediet, Joris I Rotmans, Friedo W Dekker
BACKGROUND: Monitoring of renal function is important in patients with chronic kidney disease progressing towards end-stage renal failure, both for timing the start of renal replacement therapy and for determining the prognosis on dialysis. Thus far, studies on associations between estimated glomerular filtration rate (eGFR) measurements in the pre-dialysis stage and mortality on dialysis have shown no or even inverse relations, which may result from the poor validity of serum creatinine-based estimation equations for renal function in pre-dialysis patients...
June 16, 2016: Nephrology, Dialysis, Transplantation
Bo Ravn, Anders Larsson, Johan Mårtensson, Claes-Roland Martling, Max Bell
BACKGROUND: Markers of renal function are widely used in intensive care and sudden changes are important indicators of acute kidney injury. The problem is to distinguish between disease progression/improvement from the natural variation in the patient. The aim of the present study was thus to study the normal intraday variation in ICU patients. METHODS: We studied the intra-day variation of creatinine, cystatin C and estimated GFR based on these two markers in 28 clinically stable ICU patients...
September 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
J J Dixon, K Lane, R N Dalton, Iam MacPhee, B J Philips
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
2016-06-14 11:43:29
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