eGFR--use beyond the evidence.

Area of Science:

• Nephrology
• Clinical Chemistry

Background:

• The estimated glomerular filtration rate (eGFR) algorithm is widely used but has limitations.
• Serum creatinine concentration is a traditional marker for kidney function assessment.

Purpose of the Study:

• To evaluate the limitations and validation status of the eGFR algorithm.
• To provide recommendations on the appropriate use of eGFR in clinical practice.

Main Methods:

• Review of existing literature on eGFR validation and application.
• Comparison of eGFR performance against validated methods in diverse populations.

Main Results:

• eGFR assumes average body size and lean body weight, limiting its accuracy in specific groups.
• eGFR lacks validation for safe drug dosing adjustments and population-wide screening for impaired renal function.
• eGFR accuracy is compromised in extreme or rapidly changing GFR levels and in diverse populations (elderly, obese, different races).

Conclusions:

• eGFR is not a validated tool for drug dose calculation or general population screening.
• Validated methods, such as the Cockcroft-Gault formula, should be used for drug dosing until eGFR demonstrates safety and efficacy.
• Further evidence is required to establish the safety and effectiveness of eGFR in various clinical settings and patient groups.