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 Estimating Glomerular Filtration Rate (eGFR) News Letter

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dr.moz
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عدد المساهمات : 137
العمر : 47
تاريخ التسجيل : 03/08/2008

مُساهمةموضوع: Estimating Glomerular Filtration Rate (eGFR) News Letter   السبت 6 ديسمبر - 13:01

Estimating Glomerular Filtration Rate (eGFR)



Why ?


The
Department of Health (USA) recommends implementation of routing (eGFR)
reporting by all Clinical laboratories as of April 2006.


Glomerular
filtration rate (GFR) is an important test of kidney function & knowledge
of GFR is essential for the diagnosis & management of Chronic Kidney
disease (CKD).


Serum
creatinine measurement ,awidespread test of kidney function , is insufficiently
sensitive to detect moderate (CKD) & is affected by arrange of non-renal
influences . Creatinine Clearance has significant practical problems & is
known to be inaccurate .


An
alternative is to measure serum creatinine & (eGFR) to correct for some of
the more significant non-renal influences . This approach is known to be more
sensitive for the detection of (CKD) than serum creatinine & more accurate
than creatinine clearance .


Who ?


People
with diabetes, vascular disease ,heart failure , hypertension . Urinary tract
obstruction . neurogenic bladder or surgical urinary diversion . taking
diuretics , angiotensin converting enzyme inhibitors or angiotensin II reccptor
blockers & people with a family history or genetic risk of kidney disease
should undergo regular (eGFR) surveillance .


How ?


(eGFR)
for adults is calculated using the 4-variables (i.e. serum creatinine concentration age , sex ,&
race ).In children & adolescents up to 18 years. A 5th variable
(height) has to be calculated .


Inaccurate
results may be encountered if blood creatinine levels are unstable & in
malnourished & obese individuals as well as amputccs .







(eGFR) is more sensitive
than serum creatinine & more accuratc than creatinine clearance for
detecting Chronic kidney Disease (CKD) .
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عدد المساهمات : 907
تاريخ التسجيل : 01/08/2008

مُساهمةموضوع: رد: Estimating Glomerular Filtration Rate (eGFR) News Letter   السبت 6 ديسمبر - 21:31

thanks dr.moz


Also known as: Calculated Glomerular Filtration Rate, cGFR
Formal name: Estimated Glomerular Filtration Rate
Related tests: GFR measured by inulin clearance



How is it used?
A measured GFR is considered the most accurate way to detect changes in kidney status. If kidney damage is detected early, it may be possible to prevent worsening damage if this is due to high blood pressure, diabetes or to other treatable diseases. However, measuring GFR is complicated and requires experienced personnel. Because eGFR can be calculated based on serum creatinine, an easily performed and commonly used laboratory test, it is possible to get a reasonable estimate of the actual GFR.

The creatinine clearance test also provides an estimate of renal function and of the actual GFR. However, in addition to the serum creatinine, this test requires a timed urine collection (24 hours) for creatinine measurement in order to calculate the clearance.

Another method of evaluating renal function involves the measurement of the serum level of a molecule called cystatin C. There is increasing interest in the use of this test for this purpose.




When is it ordered?
The eGFR can be determined, with no extra testing, at the same time that a sample is sent for creatinine measurement. The National Kidney Foundation (NKF) has recommended that it be calculated automatically every time a creatinine test is done. If you have had a creatinine measurement




What does the test result mean?
NOTE: A standard reference range is not available for this test. Because reference values are dependent on many factors, including patient age, gender, sample population, and test method, numeric test results have different meanings in different labs. Your lab report should include the specific reference range for your test. Lab Tests Online strongly recommends that you discuss your test results with your doctor. For more information on reference ranges, please read Reference Ranges and What They Mean.

Compared to serum creatinine, the eGFR more reliably detects kidney disease in its early stages. Because the calculation works best for estimating reduced renal function, the NKF suggests only reporting actual results once values are < 60 ml/min (normal values are 90-120 ml/min, according to the NKF). An eGFR below 60 ml/min suggests that some kidney damage has occurred. The NKF recommends that your eGFR result be interpreted in relation to your clinical history and presenting conditions.


GFR and eGFR increase during pregnancy.

A measured clearance (GFR) rather than calculated (eGFR) is recommended for:
# Persons with known kidney damage (for example as reflected by albumin or protein in the urine)
# Patients of extreme age (very old or very young)
# Patients of extreme body mass (obese, malnourished, with muscle wasting diseases)
# Persons with unusual dietary intakes, including vegetarians
# Persons with rapidly changing renal function (includes acute renal disease)
# When drug dose adjustments are necessary (persons taking drugs with significant renal toxicity and renal clearance)

The most commonly used equation for calculating the eGFR, and the one recommended by the National Kidney Foundation for general use, is called the MDRD (Modification of Diet in Renal Disease study) equation. The simple version of this equation requires only the serum creatinine, your age and gender. It may be modified depending on your racial origin.



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تاريخ التسجيل : 25/11/2008

مُساهمةموضوع: رد: Estimating Glomerular Filtration Rate (eGFR) News Letter   الأربعاء 17 ديسمبر - 6:40

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Estimating Glomerular Filtration Rate (eGFR) News Letter
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