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Related Concept Videos

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

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

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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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Renal Clearance01:23

Renal Clearance

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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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Glomerular Filtration Rate and its Regulation01:28

Glomerular Filtration Rate and its Regulation

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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.
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
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Renal Drug Excretion: Glomerular Filtration01:02

Renal Drug Excretion: Glomerular Filtration

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The kidney serves as the primary organ responsible for eliminating drugs and their metabolites from the body. This process, known as renal elimination, starts with glomerular filtration and results in urine formation. Each kidney houses millions of functional units called nephrons, where urine production occurs. A nephron has two main components: a renal corpuscle and a renal tubule.
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....
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Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

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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.
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...
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Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

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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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Updated: Oct 12, 2025

Transdermal Measurement of Glomerular Filtration Rate in Mice
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Reevaluating race and the glomerular filtration rate calculator.

Claretha Lyas1, Kim Zuber, Jane Davis

  • 1Claretha Lyas is an assistant professor in the Division of Nephrology and director of the Chronic Kidney Disease Clinic at the University of Alabama at Birmingham. Kim Zuber is executive director of the American Academy of Nephrology PAs, based in St. Petersburg, Fla. Jane Davis is an NP in the Division of Nephrology at the University of Alabama at Birmingham. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|November 23, 2021
PubMed
Summary
This summary is machine-generated.

Race can be removed from estimated glomerular filtration rate (eGFR) calculations without harm. A new CKD-EPI equation, without race adjustment and potentially including cystatin C, offers improved accuracy for kidney function assessment.

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Area of Science:

  • Nephrology
  • Medical Diagnostics
  • Health Equity

Background:

  • Estimated glomerular filtration rate (eGFR) calculations historically incorporated race adjustments.
  • Concerns regarding racial bias in medical algorithms have prompted a re-evaluation of race in eGFR.
  • The inclusion of race in eGFR has been questioned for its potential to perpetuate health disparities.

Purpose of the Study:

  • To review the appropriateness of including race in eGFR calculations.
  • To determine if race can be eliminated from eGFR equations without negative patient outcomes.
  • To recommend updates to eGFR calculation methodologies.

Main Methods:

  • Convening an expert task force by the American Society of Nephrology and National Kidney Foundation.
  • Conducting a deliberative review of existing evidence and methodologies.
  • Analyzing the impact of removing race from eGFR equations.

Main Results:

  • The review concluded that race can be removed from eGFR calculators.
  • No adverse reactions were observed in any patient group upon removal of race.
  • A refitted CKD-EPI equation without race adjustment is ready for immediate use in US laboratories.

Conclusions:

  • Eliminating race from eGFR calculations is feasible and safe.
  • The updated CKD-EPI equation provides a more equitable approach to assessing kidney function.
  • Increased utilization of cystatin C in eGFR calculations is recommended for enhanced accuracy.