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National Kidney Foundation Guideline on Estimation of Glomerular Filtration Rate

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National Kidney Foundation Guideline on Estimation of Glomerular Filtration Rate

Post  Admin on Sun Oct 25, 2015 4:29 pm

National Kidney Foundation Guideline on Estimation of the Glomerular Filtration Rate

Arrow Estimates of the Glomerular Filtration Rate are the best overall indices of the level of kidney function.

Arrow Serum creatinine concentration alone should not be used to assess the level of kidney function.
Reason: tubular and extra-renal secretion of creatinine, the wide between individual variation in creatinine production and the differences between various analytical methods for creatinine.

Arrow The level of GFR should be estimated from prediction equations that take into account the serum creatinine concentration and some or all of the following variables: age, gender, race, and body size.
The following equations provide useful estimates of GFR:
* In adults, the MDRD Study and Cockcroft- Gault equations
* In children, the Schwartz and Counahan- Barratt equations.

Arrow Clinical laboratories should report an estimate of GFR using a prediction equation, in addition to reporting the serum creatinine measurement.
Arrow Autoanalyser manufacturers and clinical laboratories should calibrate serum creatinine assays using an international standard.
Arrow Measurement of creatinine clearance using timed (for example, 24-hour) urine collections does not improve the estimate of GFR over that provided by prediction equations.
A 24-hour urine sample provides useful information for:
* Estimation of GFR in individuals with exceptional dietary intake (vegetarian diet, creatine supplements) or muscle mass (amputation, malnutrition, muscle wasting)
* Assessment of diet and nutritional status
* Need to start dialysis.

Source: Clin Biochem Rev. 2003 Aug; 24(3): 95–98.

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