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Glomerular filtration rate measurement and prediction equations

Ariana Aguiar Soares1, Tatiana Falcão Eyff, Raquel Barth Campani

  • 1Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.

Clinical Chemistry and Laboratory Medicine
|September 5, 2009
PubMed

Insights

Detecting chronic kidney disease (CKD) involves estimating glomerular filtration rate (GFR) using creatinine-based formulas like MDRD and CKD-EPI. The CKD-EPI equation generally offers improved GFR estimation accuracy over MDRD.

Area of Science:

  • Nephrology
  • Clinical Chemistry

Background:

  • Chronic kidney disease (CKD) is defined by kidney damage or a glomerular filtration rate (GFR) below 60 mL/min/1.73 m² for over three months.
  • Serum creatinine measurement is standard for assessing kidney function, often incorporated into estimated GFR (eGFR) formulas.

Purpose of the Study:

  • To review current recommendations for CKD detection.
  • To highlight the characteristics and limitations of various GFR estimating equations.
  • To discuss challenges in evaluating urinary albumin excretion.

Main Methods:

  • Comparison of GFR estimating equations, including the Modification of Diet in Renal Disease (MDRD) study equation and the newer Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.
  • Evaluation of serum creatinine and cystatin C as markers for GFR estimation.
  • Review of methods for assessing urinary albumin excretion.

Main Results:

  • The MDRD equation performs acceptably for known CKD patients but may underestimate GFR in populations with unknown kidney status.
  • The CKD-EPI equation demonstrates superior performance compared to the MDRD equation.
  • Cystatin C shows potential as a more sensitive marker for GFR than creatinine.

Conclusions:

  • Accurate GFR estimation is crucial for CKD detection and management.
  • The CKD-EPI equation is recommended for improved GFR accuracy.
  • Careful evaluation of urinary albumin excretion is essential alongside GFR estimation.

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