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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.
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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...
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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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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.
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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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ACR Appropriateness Criteria indeterminate renal mass.

Marta E Heilbrun1, Erick M Remer2, David D Casalino3

  • 1University of Utah, Salt Lake City, Utah.

Journal of the American College of Radiology : JACR
|April 6, 2015
PubMed
Summary

Indeterminate renal masses require advanced imaging like CT, MRI, or biopsy for diagnosis. Active surveillance is an option for small renal cell carcinomas in high-risk patients.

Keywords:
Appropriateness Criteriadiagnostic imagingrenal cell carcinomarenal cystrenal mass

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Area of Science:

  • Radiology
  • Oncology
  • Nephrology

Background:

  • Renal masses are frequently found incidentally in asymptomatic patients.
  • Indeterminate renal masses lack definitive benign or malignant classification upon initial detection.

Purpose of the Study:

  • To review current and emerging technologies for characterizing indeterminate renal masses.
  • To discuss diagnostic strategies, including imaging and biopsy, based on ACR Appropriateness Criteria.

Main Methods:

  • Review of current literature on renal mass characterization.
  • Analysis of established and emerging imaging modalities (CT, MRI, ultrasonography, PET/CT).
  • Consideration of percutaneous biopsy and active surveillance strategies.

Main Results:

  • Standard imaging with IV contrast (CT, MRI, ultrasonography) are primary tools.
  • Advanced techniques like dual-energy CT, contrast-enhanced ultrasonography, and PET/CT show promise.
  • MRI, ultrasonography, and biopsy offer alternatives when IV contrast is contraindicated.
  • Active surveillance is a viable option for small renal cell carcinomas (≤4 cm) in select patients.

Conclusions:

  • A multidisciplinary approach and evidence-based guidelines (ACR Appropriateness Criteria) inform the management of indeterminate renal masses.
  • Technology advancements are improving diagnostic accuracy.
  • Patient-specific factors, including surgical risk and contrast contraindications, guide the choice of diagnostic and management strategies.