Performance Of Chronic Kidney Disease-epidemiology Study Equations For Estimating Glomerular Filtration Rate Before And After Nephrectomy

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 14 Jun 2010 - 0:00 PDT

email to a friend   printer friendly   opinions  

UroToday.com - Accurate renal function determination is increasingly of more importance as we assess patients with localized renal tumors in determining the need for aggressive partial nephrectomy versus radical nephrectomy. This is essential for proper prevention and management of chronic kidney disease due to nephron loss and ischemic injury.

There are presently several formulas that can be used in addition to serum creatinine to evaluate glomerular filtration rate. This study determined which of these formulas could most accurately reflect the measured glomerular filtration rate before and after nephrectomy.

The study was performed on 7,611 patients and performance of the Cockcroft-Gault, Modification of Diet in Renal Disease Study, re-expressed Modification of Diet in Renal Disease Study and Chronic Kidney Disease-Epidemiology Study equations were determined using serum creatinine, age, gender, weight and body surface area. The performance of serum creatinine, reciprocal serum creatinine and the four formulas was compared with the measured GFR. As expected, there was poor correlation between serum creatinine and the measured GFR, however the reciprocal serum creatinine and the Chronic Kidney Disease-Epidemiology Study equation performed with greatest precision and accuracy and the least biased of all the equations.

Therefore, in the clinical analysis of patients with potential chronic renal disease in assessing their renal function the newly developed, serum creatinine based Chronic Kidney Disease-Epidemiology Study equation will provide the best accuracy in rendering direct glomerular filtration rate measurement. However, a quick and easy evaluation of this clinical factor can be determined by the reciprocal serum creatinine. Serum creatinine alone is a very poor indicator of overall renal function and glomerular filtration rate.

Lane BR, Demirjian S, Weight CJ, Larson BT, Poggio ED, Campbell SC
J Urol. 2010 Mar;183(3):896-901
doi: 10.1016/j.juro.2009.11.023

Written by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com

Copyright © 2010 - UroToday

• Additional
• References
• Citations