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

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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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Determination of Renal Drug Clearance: Graphical and Midpoint Methods01:07

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Renal clearance, a crucial parameter in pharmacokinetics, can be determined using two different methods: the graphical method and the midpoint method. These methods provide insights into the rate of drug excretion by the kidneys and aid in assessing renal function.
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Renal Drug Clearance: Comparison Between Renal Excretion Methods01:08

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Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
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Updated: Jan 18, 2026

Assessment of Kidney Function in Mouse Models of Glomerular Disease
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Polygenic Risk Scores Predicting Estimated GFR Validated With Iohexol Clearance.

Bjørn O Eriksen1,2, Matthis Kretzler3,4, Viji Nair3

  • 1Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway.

Kidney International Reports
|January 16, 2026
PubMed
Summary
This summary is machine-generated.

Genome-wide association studies using estimated glomerular filtration rate (eGFR) may be biased. This study found genetic effects on measured GFR (mGFR) were larger than on eGFR, suggesting validation is needed.

Keywords:
chronic kidney diseaseestimated glomerular filtration rategenetic expressionglomerular filtration ratemeasured glomerular filtration rate

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Area of Science:

  • Genetics
  • Nephrology
  • Biostatistics

Background:

  • Genome-wide association studies (GWAS) commonly use estimated glomerular filtration rate (eGFR) as a proxy for measured glomerular filtration rate (mGFR) due to cost and complexity.
  • However, eGFR is influenced by non-GFR factors, potentially introducing bias into GWAS findings.
  • This study directly compares genetic effects on mGFR versus eGFR to assess this potential bias.

Purpose of the Study:

  • To investigate the potential bias in GWAS results by comparing aggregate genetic effects on measured GFR (mGFR) and estimated glomerular filtration rate (eGFR).

Main Methods:

  • The study analyzed 1492 individuals from the Renal Iohexol Clearance Survey (RENIS) cohort.
  • Measured GFR (mGFR) was determined using iohexol clearance.
  • Three published polygenic risk scores (PGS) for eGFR were compared with mGFR, assessing narrow-sense heritability (h²), and the mean effect of single nucleotide variants (SNVs).

Main Results:

  • Polygenic risk scores (PGS) performed differently for mGFR and eGFR, with best prediction for eGFRcr.
  • However, the magnitude of genetic effects (beta coefficients) for SNVs was 11% to 46% greater for mGFR than for eGFR across most comparisons.
  • Measured GFR (mGFR) exhibited higher heritability (h² = 0.47) compared to eGFRcr (0.21), eGFRcys (0.37), and eGFRcr-cys (0.42).

Conclusions:

  • Single nucleotide variants (SNVs) with non-GFR effects on creatinine and cystatin C impact GWAS results.
  • The findings suggest that GWAS results derived from eGFR should be validated using more precise experimental methods.