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Use of Cystatin C to Assess Kidney Function



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How Can We Turn the Serum Creatinine Into a Better Estimate of GFR?

Slide 11

August 2011

Therefore, efforts have been devoted to make serum creatinine a better estimate of GFR. The main factor that varies between individuals and influences serum creatinine independent of GFR is muscle mass, which in turn is the key determinant of creatinine production. Therefore, equations have been developed that estimate what a person’s creatinine production should be. The oldest example of such an equation is the Cockroft-Gault equation. This equation estimates creatinine clearance based upon serum creatinine together with age, gender, and weight. The MDRD estimated GFR, or eGFR, was developed using data from the Modification of Diet in Renal Disease study. This study only included patients with chronic kidney disease, who were placed on various diets in order to determine if a low-protein diet helped preserve kidney function. As part of the study, patient’s had their GFR measured using iothalamate clearance. The investigators then used data in their study to develop an equation that best estimated GFR.  One problem with the MDRD equation is that it was developed using only persons with CKD, and therefore does not perform very well in normal individuals. Therefore, a newer equation has been developed using a mixed population of patients with and without CKD. This equation is called the CKD-EPI equation. So far it is used mostly for research, but may make it into clinical practice sometime in the future.

Can We Turn the Serum Into a Better Estimate?

 


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