| Understanding estimated glomerular filtration rate: implications for identifying chronic kidney disease. | |
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MedLine Citation:
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PMID: 17420668 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Glomerular filtration rate (GFR) can be estimated using serum markers such as serum creatinine (SCr) or cystatin C. This review presents new insights into estimated GFR based on theory, validation studies, SCr assay standardization, cystatin C, and longitudinal comparison with measured GFR. RECENT FINDINGS: The estimation of GFR by SCr differs in health and in chronic kidney disease (CKD) due to differences in GFR range and in creatinine production between these two populations. Among populations with normal baseline GFR, there is a more rapid decline in measured GFR than in SCr-based estimated GFR. While elevated SCr is specific for CKD, other disease processes may lead to elevated cystatin C. Validation is improved by refitting equation coefficients to compare populations, recognizing the asymmetry between estimated GFR and measured GFR, and using residual plots instead of Bland-Altman plots to assess bias. SUMMARY: As a screening test, SCr should be interpreted as a marker of CKD probability in the context of the patient's clinical presentation. Measured GFR or creatinine clearance may be helpful in high-risk patients with normal SCr levels. GFR estimating equations should be reserved for patients with identified CKD. Standardized SCr and cystatin C assays are needed. |
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Authors:
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Andrew D Rule |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in nephrology and hypertension Volume: 16 ISSN: 1062-4821 ISO Abbreviation: Curr. Opin. Nephrol. Hypertens. Publication Date: 2007 May |
Date Detail:
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Created Date: 2007-04-10 Completed Date: 2007-06-07 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 9303753 Medline TA: Curr Opin Nephrol Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 242-9 Citation Subset: IM |
Affiliation:
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Division of Nephrology, Mayo Clinic, Rochester, Minnesota, USA. rule.andrew@mayo.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Biological Markers
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blood* Cardiovascular Diseases / blood, diagnosis Chronic Disease Creatinine / blood Cystatin C Cystatins / blood Glomerular Filtration Rate* Humans Kidney Diseases / blood, diagnosis*, physiopathology Kidney Function Tests / methods Mass Screening / methods*, standards Models, Biological Predictive Value of Tests Reproducibility of Results Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/CST3 protein, human; 0/Cystatin C; 0/Cystatins; 60-27-5/Creatinine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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