ESTIMATING GLOMERULAR FILTRATION RATE (eGFR)
04/24/2003
Estimating Glomerular Filtration Rate (eGFR)
Why?
The Department of Health (USA) recommends implementation of routine (eGFR) reporting by all Clinical laboratories as of April 2006.
Glomerular filtration rate (GFR) is an important test of kidney function and knowledge of GFR is essential for the diagnosis and management of Chronic Kidney Disease (CKD).
Serum creatinine measurement, a widespread test of kidney function, is insufficiently sensitive to detect moderate (CKD) and is affected by a range of non-renal influences. Creatinine Clearance has significant practical problems and is known to be inaccurate.
An alternative is to measure serum creatinine and (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 and 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 receptor blockers and 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, and 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, malnourished and obese individuals as well as amputees…
What does it mean?
(eGFR) is the pillar of CKD diagnosis, staging and management but is only one component of clinical assessment done by the physician.
|
Stage |
GFR* |
Description |
|
1 |
90-100 |
Normal kidney function but urine findings or structural abnormalities or genetic trait point to kidney disease |
|
2 |
60-89 |
Mildly reduced kidney function, and other findings (as for stage 1) point to kidney disease |
|
3 |
30-59 |
Moderately reduced kidney function |
|
4 |
15-29 |
Severely reduced kidney function |
|
5 |
<15 |
End stage kidney failure (sometimes call established renal failure) |
* All GFR values are normalized to an average surface area (size) of 1.73m2
|
