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

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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 marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
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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.
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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...
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A High-throughput Method for Measurement of Glomerular Filtration Rate in Conscious Mice
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Measured Glomerular Filtration Rate: The Query for a Workable Golden Standard Technique.

Marijn M Speeckaert1,2, Jesse Seegmiller3, Griet Glorieux1

  • 1Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium.

Journal of Personalized Medicine
|October 23, 2021
PubMed
Summary
This summary is machine-generated.

Standardizing measured glomerular filtration rate (mGFR) methods is crucial. This review calls for standardization of markers, analytical methods, and procedures for accurate kidney function assessment.

Keywords:
contrast mediaglomerular filtration rateinulinradioactive tracers

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Area of Science:

  • Nephrology
  • Clinical Chemistry
  • Biomarker Discovery

Background:

  • Inulin clearance was the reference for measured glomerular filtration rate (mGFR), but limitations exist.
  • Serum creatinine has known limitations; exogenous markers like iohexol, iothalamate, and radioisotopes (e.g., 51Cr-EDTA) are used for accurate GFR estimation.
  • Lack of standardization in exogenous marker assays and protocols leads to variability in mGFR results.

Purpose of the Study:

  • To highlight the need for standardization of measured glomerular filtration rate (mGFR) methods.
  • To address the scientific and regulatory challenges hindering the clinical use of current mGFR techniques.
  • To advocate for the development of reliable endogenous filtration markers for accurate GFR estimation.

Main Methods:

  • Review of existing literature on exogenous filtration markers for GFR measurement.
  • Analysis of limitations associated with inulin, serum creatinine, and various exogenous markers (radioactive and non-radioactive).
  • Discussion of challenges including lack of certified reference materials, standardized protocols, and regulatory hurdles.

Main Results:

  • Current exogenous mGFR methods (iohexol, iothalamate, radioisotopes) lack standardization in markers, analytical techniques, and procedural protocols.
  • Significant variations in reported mGFR results question the reliability of these methods as a gold standard.
  • Regulatory issues further restrict the clinical application of existing mGFR techniques.

Conclusions:

  • Standardization of the filtration marker, analytical method, and GFR determination procedure is urgently required for mGFR.
  • Development of an endogenous filtration marker or panel for single-blood-draw GFR estimation, comparable in accuracy to mGFR, is needed.
  • Standardization will enhance the scientific reliability and clinical utility of kidney function assessment.