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Licensed Unlicensed Requires Authentication Published by De Gruyter November 7, 2006

Renal function – estimation of glomerular filtration rate

  • Lothar Thomas and Andreas R. Huber

Abstract

Assessment and follow-up of renal dysfunction is important in the early detection and management of chronic kidney disease. The glomerular filtration rate (GFR) is the most accurate measurement of kidney disease and is reduced before the onset of clinical symptoms. Drawbacks to the measurement of GFR include the high cost and incompatibility with routine laboratory monitoring. Serum creatinine determination is a mainstay in the routine laboratory profile of renal function. The measurement of serum cystatin C has been proposed as a more sensitive marker for GFR. According to National Kidney Foundation-K/DOQ1 clinical guidelines for chronic kidney disease, serum markers should not be used alone to assess GFR. Based on prediction equations, clinical laboratories should report an estimate of GFR, in addition to reporting the serum value. In this article, information is presented on how best to estimate GFR using prediction equations for adults and for children. Using serum creatinine concentration with the Modification of Diet in Renal Disease (MDRD) study equation offers a suitable estimation of GFR in adults. The cystatin C prediction equation with the use of a prepubertal factor seems superior to creatinine-based prediction equations in children of <14years.

Clin Chem Lab Med 2006;44:1295–302.


Corresponding author: Lothar Thomas, MD, Professor of Medicine, Department of Laboratory Medicine, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488 Frankfurt, Germany Phone: +49-69-76013252, Fax: +49-69-787340,

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Received: 2006-6-5
Accepted: 2006-7-4
Published Online: 2006-11-7
Published in Print: 2006-11-1

©2006 by Walter de Gruyter Berlin New York

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