Related Experiment Video
Updated: Oct 21, 2025
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
16.4K
[Evaluation of kidney function in older adults].
Jorge Vega1, Juan Pablo Huidobro E2
1Departamento de Medicina, Escuela de Medicina, Universidad de Valparaíso, Viña del Mar, Chile.
Revista Medica De Chile
|September 3, 2021
Summary
Estimating kidney function in older adults using standard formulas can lead to misclassification of chronic kidney disease (CKD). Newer formulas like FAS and BIS offer improved accuracy for glomerular filtration rate estimation in this population.
Area of Science:
- Nephrology
- Geriatrics
- Clinical Chemistry
Background:
- Accurate assessment of renal function is crucial for managing older adults.
- Commonly used formulas (Cockcroft-Gault, MDRD, CKD-EPI) show inaccuracies in estimating glomerular filtration rate (GFR) in individuals over 70.
- Inaccurate GFR estimations can lead to misdiagnosis of chronic kidney disease (CKD), impacting patient care and health systems.
Purpose of the Study:
- To review the performance of various formulas for estimating GFR in older adults.
- To compare the accuracy of established and novel GFR estimation equations in elderly populations.
- To recommend the most reliable formulas for GFR assessment in geriatric patients.
Main Methods:
- Systematic review of studies evaluating GFR estimation formulas in older adults.
- Analysis of formula performance against reference methods for GFR measurement.
- Comparison of Cockcroft-Gault, MDRD, CKD-EPI, FAS, and BIS formulas.
Main Results:
- Cockcroft-Gault often underestimates GFR, while MDRD tends to overestimate it in adults over 70.
- CKD-EPI exhibits unpredictable behavior in this age group.
- Emerging formulas like FAS and BIS demonstrate greater accuracy in estimating GFR in older adults.
Conclusions:
- Standard GFR estimation formulas are unreliable for older adults, leading to potential misclassification of CKD.
- Newer formulas, such as FAS and BIS, provide more accurate GFR estimations in the elderly.
- Adoption of validated, accurate formulas is recommended for improved management of kidney function in older populations.
Related Concept Videos
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
93
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
93
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
34
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.
34
01:17Factors Affecting Renal Clearance: Renal Impairment
210
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...
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...
210
01:24Serum Studies: Renal Function Tests
150
Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
150
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
32
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
32
01:28Chronic Kidney Disease III: Interprofessional Care
143
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...
143