[Glomerular filtration rate estimation and measurement: The quest for precision]

Area of Science:

• Nephrology
• Clinical Chemistry

Background:

• Glomerular filtration rate (GFR) is the best indicator of overall kidney function.
• Current clinical practice relies on creatinine-based equations for GFR estimation.
• Serum creatinine has known limitations as a biomarker for renal function.

Purpose of the Study:

• To review current creatinine-based equations for GFR estimation.
• To explore the potential of cystatin C as an alternative biomarker.
• To discuss the value of measured GFR in specific clinical scenarios.

Main Methods:

• Literature review of current GFR estimation methods.
• Discussion of limitations of serum creatinine.
• Analysis of cystatin C as a biomarker.
• Evaluation of measured GFR techniques.

Main Results:

• Creatinine-based equations have inherent limitations affecting accuracy.
• Cystatin C shows promise as a more reliable biomarker for GFR.
• Measured GFR is valuable in select patient populations and situations.

Conclusions:

• Rethinking GFR estimation beyond standard creatinine markers is necessary.
• Cystatin C and measured GFR offer improved accuracy in specific contexts.
• Optimizing GFR assessment is crucial for effective renal function management.