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Measure GFR

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
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...
December 30, 2017: 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
We were interested to read the recent article in Diabetic Medicine by Bjornstad et al. [1], who found that high estimated GFR (eGFR) and albumin excretion rates predicted early renal function decline in 91/308 people with Type 1 diabetes mellitus. Early renal function decline is defined as a three- to fivefold increase in annual eGFR loss compared with the normal physiology of aging (~1 ml/min/1.73m2 /year). This article is protected by copyright. All rights reserved.
November 28, 2017: 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...
November 30, 2017: Critical Care Medicine
Adam Shardlow, Natasha J McIntyre, Simon D S Fraser, Paul Roderick, James Raftery, Richard J Fluck, Christopher W McIntyre, Maarten W Taal
BACKGROUND: To reduce over-diagnosis of chronic kidney disease (CKD) resulting from the inaccuracy of creatinine-based estimates of glomerular filtration rate (GFR), UK and international guidelines recommend that cystatin-C-based estimates of GFR be used to confirm or exclude the diagnosis in people with GFR 45-59 ml/min/1.73 m2 and no albuminuria (CKD G3aA1). Whilst there is good evidence for cystatin C being a marker of GFR and risk in people with CKD, its use to define CKD in this manner has not been evaluated in primary care, the setting in which most people with GFR in this range are managed...
October 2017: PLoS Medicine
Xilian Qiu, Chunyong Liu, Yuqiu Ye, Huiqun Li, Yanbing Chen, Yongmei Fu, Zhenjie Liu, Xianzhang Huang, Yunqiang Zhang, Xueyuan Liao, Hongyong Liu, Wenbo Zhao, Xun Liu
BACKGROUND: Serum biomarkers, such as serum creatinine (SCr) and serum cystatin C (SCysC), have been widely used to evaluate renal function in patients who have chronic kidney disease (CKD). OBJECTIVE: This article aims to assess the value of determining SCr and SCysC levels in patients that have long-term kidney disease. Approaches: MEDLINE, EmBase, the Cochrane Library and other databases were searched using both MeSH terms and text words to collect research that assessed the diagnostic value of using SCr and SCysC to evaluate Glomerular Filtration Rate (GFR) in patients with CKD...
September 22, 2017: Oncotarget
Ahmed Alaini, Deepak Malhotra, Helbert Rondon-Berrios, Christos P Argyropoulos, Zeid J Khitan, Dominic S C Raj, Mark Rohrscheib, Joseph I Shapiro, Antonios H Tzamaloukas
The development of formulas estimating glomerular filtration rate (eGFR) from serum creatinine and cystatin C and accounting for certain variables affecting the production rate of these biomarkers, including ethnicity, gender and age, has led to the current scheme of diagnosing and staging chronic kidney disease (CKD), which is based on eGFR values and albuminuria. This scheme has been applied extensively in various populations and has led to the current estimates of prevalence of CKD. In addition, this scheme is applied in clinical studies evaluating the risks of CKD and the efficacy of various interventions directed towards improving its course...
September 26, 2017: World Journal of Methodology
Katerina Markoska, Martin Pejchinovski, Claudia Pontillo, Petra Zürbig, Lotte Jacobs, Andrew Smith, Jelka Masin-Spasovska, Olivera Stojceva-Taneva, Momir Polenakovic, Fulvio Magni, Harald Mischak, Goce Spasovski
Background: An improvement in the glomerular filtration rate (GFR) of chronic kidney disease patients has been an underestimated clinical outcome. Although this may be considered as an unexpected disease course, it may provide some insights into possible mechanisms underlying disease remission and/or regression. Therefore, our aim was to identify urinary peptide biomarkers associated with an improvement in estimated GFR (eGFR) over time and to improve patient stratification. Methods: Capillary electrophoresis coupled with mass spectrometry (CE-MS) was employed to evaluate the urine peptidome of patients with different types of renal diseases...
September 1, 2017: Nephrology, Dialysis, Transplantation
Eric Yayo, Mireille Ayé, Carine Yao, Appolinaire Gnionsahé, Marie-Laure Attoungbré, Etienne Cavalier, Hans Pottel, Dagui Monnet, Pierre Delanaye
Background: Establishment of normal reference values for glomerular filtration rate (GFR) is mandatory in nephrology. However, no data are available for measured GFR (mGFR) in Africa. Methods: GFR was measured in 237 healthy adult subjects (103 women and 134 men, mean age 34 ± 10 years) by iohexol plasma clearance. Results: The mean mGFR was 103 ± 17 mL/min/1.73 m 2 and the median value was 103 mL/min/1.73 m 2 (2.5th and 97.5th percentiles are 76 and 137 mL/min/1...
August 9, 2017: Nephrology, Dialysis, Transplantation
Richard Solomon, Stuart Goldstein
PURPOSE OF REVIEW: Measurement of glomerular filtration rate is an essential tool for determining the health or dysfunction of the kidney. The glomerular filtration rate is a dynamic function that can change almost instantaneously in response to stressors. Despite its central role in nephrology, there are no techniques available to the clinician for monitoring glomerular filtration rate in real time. Recent advances in technology to measure fluorescent compounds through the skin are providing a new approach for real-time monitoring of glomerular filtration rate...
December 2017: Current Opinion in Critical Care
Evelien Snauwaert, Wim Van Biesen, Ann Raes, Els Holvoet, Griet Glorieux, Koen Van Hoeck, Maria Van Dyck, Nathalie Godefroid, Raymond Vanholder, Sanne Roels, Johan Vande Walle, Sunny Eloot
BACKGROUND: Chronic kidney disease (CKD) in childhood is characterised by the accumulation of uraemic toxins resulting in a multisystem disorder that has a negative impact on quality of life. Childhood CKD is predominantly defined by a decrease in glomerular filtration rate, estimated (eGFR) by a single serum measurement of endogenous biomarkers, e.g. creatinine. The objective of this study was to evaluate how accurately eGFR predicts the concentration of uraemic toxins in a paediatric CKD cohort...
September 22, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
2017-09-26 22:47:05
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