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Related Concept Videos

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug 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...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug 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...
Glomerular Filtration Rate and its Regulation01:28

Glomerular Filtration Rate and its Regulation

The Glomerular Filtration Rate (GFR) is a measure of kidney function, reflecting the volume of filtrate formed per minute in the kidneys. On average, GFR is approximately 125 mL/min in males and 105 mL/min in females. Maintaining a relatively constant GFR is essential for the kidneys to effectively regulate body fluid homeostasis and maintain extracellular stability.
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
The myogenic...
Renal Drug Excretion: Glomerular Filtration01:02

Renal Drug Excretion: Glomerular Filtration

The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles.
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug 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...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors 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...

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Transdermal Measurement of Glomerular Filtration Rate in Mice
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Published on: October 21, 2018

Advances in glomerular filtration rate-estimating equations.

Lesley A Stevens1, Smita Padala, Andrew S Levey

  • 1Division of Nephrology, Tufts Medical Center, Boston, Massachusetts 02111, USA. LStevens1@tuftsmedicalcenter.org

Current Opinion in Nephrology and Hypertension
|April 16, 2010
PubMed
Summary

Estimated glomerular filtration rate (eGFR) reporting improves clinical practice for chronic kidney disease (CKD). Understanding the strengths and limitations of creatinine and cystatin C equations is crucial for accurate eGFR assessment.

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Area of Science:

  • Nephrology
  • Clinical Chemistry
  • Public Health

Background:

  • Estimated glomerular filtration rate (eGFR) is routinely reported by clinical laboratories.
  • Lower eGFR levels correlate with adverse health outcomes, including acute kidney injury and medical errors.

Purpose of the Study:

  • To review the performance of current creatinine and cystatin C-based eGFR estimating equations.
  • To demonstrate the utility of eGFR in public health and clinical practice.

Main Methods:

  • Review of current creatinine and cystatin C-based eGFR estimating equations.
  • Analysis of eGFR reporting impact on clinical practice and patient referrals.

Main Results:

  • The CKD-EPI equation shows improved performance and risk prediction over the MDRD study equation.
  • Cystatin C-based equations may lack accuracy across diverse populations.
  • eGFR reporting has increased nephrology referrals, but not excessively.

Conclusions:

  • eGFR reporting enhances clinical practice for CKD management.
  • Optimal use of eGFR requires understanding equation strengths and limitations.
  • Development of filtration markers less dependent on non-GFR determinants is needed for improved eGFR accuracy.