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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

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. This equation is...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
Factors Affecting Renal Clearance: Renal Impairment01:17

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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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Glomerular Filtration Rate and its Regulation01:28

Glomerular Filtration Rate and its Regulation

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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Transdermal Measurement of Glomerular Filtration Rate in Mice
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Measured and Estimated Glomerular Filtration Rates and Risk of Adverse Health Outcomes.

Edouard L Fu1,2, Antoine Créon2, Morgan E Grams3

  • 1Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.

JAMA
|June 4, 2026
PubMed
Summary

Measured glomerular filtration rate (mGFR) at 60 mL/min/1.73 m2 is linked to increased mortality and kidney failure risk. Estimated GFR using both creatinine and cystatin C (eGFRcr-cys) best reflects this risk compared to other estimations.

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Last Updated: Jun 5, 2026

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Epidemiology

Background:

  • Lower estimated glomerular filtration rate (eGFR) correlates with adverse health outcomes, including death and kidney/cardiovascular events.
  • The prognostic value of measured glomerular filtration rate (mGFR) regarding these outcomes is not well-established.

Purpose of the Study:

  • To determine the association between mGFR and adverse clinical outcomes.
  • To compare the predictive power of mGFR with various eGFR estimations for these outcomes.

Main Methods:

  • A retrospective cohort study involving 6174 adults in Stockholm, Sweden (2011-2021).
  • mGFR was measured via iohexol plasma clearance.
  • eGFR was calculated using plasma creatinine (eGFRcr), cystatin C (eGFRcys), or both (eGFRcr-cys) with CKD-EPI equations.
  • Primary outcomes included all-cause mortality and kidney failure requiring replacement therapy.

Main Results:

  • An mGFR of 60 mL/min/1.73 m2 was associated with significantly higher rates of all-cause mortality and kidney failure compared to an mGFR of 90 mL/min/1.73 m2.
  • The association between mGFR and mortality was most accurately reflected by eGFRcr-cys.
  • eGFRcr underestimated the mortality risk, while eGFRcys overestimated it when compared to mGFR.

Conclusions:

  • An mGFR threshold of 60 mL/min/1.73 m2 is supported as a marker for increased mortality and kidney failure risk, aligning with current CKD definitions.
  • eGFRcr-cys provides the most comparable risk assessment to mGFR for mortality prediction, outperforming eGFRcr and eGFRcys individually.