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Published on: November 8, 2015
Measured GFR in Routine Clinical Practice-The Promise of Dried Blood Spots
Petter Bjornstad1, Amy B Karger1, David M Maahs1
1Department of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO; Barbara Davis Center for Diabetes, University of Colorado, Denver, Aurora, CO; Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine, Minneapolis, MN; and Department of Pediatric Endocrinology, Stanford University School of Medicine, Palo Alto, CA.
Abstract:
Accurate determination of glomerular filtration rate (GFR) is crucial for the diagnosis of kidney disease. Estimated GFR (eGFR) calculated by serum creatinine and/or cystatin C is a mainstay in clinical practice and epidemiologic research but lacks precision and accuracy until GFR <60 mL/min/1.73 m2. Furthermore, eGFR may not precisely and accurately represent changes in GFR longitudinally. The lack of precision and accuracy is of concern in populations at high risk for kidney disease, as the dissociation between changes in eGFR and GFR may lead to missed diagnoses of early kidney disease. Therefore, improved methods to quantify GFR are needed. Whereas direct measures of GFR have been too cumbersome for screening and ambulatory care, a practical method of measuring GFR by iohexol clearance using dried capillary blood spots exists. In this review, we examine the current literature and data addressing GFR measurements by dried capillary blood spots and its potential application in high-risk groups.
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