Related Experiment Video
Updated: Jul 11, 2026
09:16
Assessment of Kidney Function in Mouse Models of Glomerular Disease
Published on: June 30, 2018
Review article: renal function assessment in cirrhosis - difficulties and alternative measurements
E Cholongitas1, V Shusang, L Marelli
1Liver Transplantation and Hepatobiliary Medicine Unit, Royal Free Hospital, London, UK.
Alimentary Pharmacology & Therapeutics
|September 20, 2007
Summary
Serum creatinine is an unreliable marker for assessing kidney function in cirrhosis patients. New markers like cystatin C are needed for accurate glomerular filtration rate (GFR) estimation.
Area of Science:
- Nephrology
- Hepatology
- Clinical Chemistry
Background:
- Renal function is a critical prognostic indicator in cirrhosis patients, impacting liver transplantation decisions.
- Serum creatinine is a component of the Model for End-Stage Liver Disease (MELD) score for liver transplant prioritization.
Purpose of the Study:
- To review the accuracy of surrogate markers for assessing glomerular filtration rate (GFR) in patients with cirrhosis.
Main Methods:
- Literature review of PubMed for GFR evaluation markers and factors affecting their accuracy in cirrhosis.
Main Results:
- Serum creatinine is an unreliable GFR marker in cirrhosis.
- Exogenous marker clearance is the gold standard but impractical.
- Common formulas (Cockcroft-Gault, MDRD) rely on creatinine and have limitations.
Conclusions:
- Inaccurate serum creatinine and derived formulas necessitate alternative markers like cystatin C.
- New formulas require formal evaluation in cirrhosis for reliable GFR surrogates.
Related Concept Videos
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
01:17Factors Affecting Renal Clearance: Renal Impairment
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
01:24Serum Studies: Renal Function Tests
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...