The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool

The prevalence of chronic kidney disease (CKD) continues to increase worldwide, as well as the associated morbidity and mortality and the consequences on the patients' quality of life and countries' economies. CKD often evolves without being recognized by patients and physicians, although...

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Autores principales:	Ana Maria Cusumano, Carmen Tzanno-Martins, Guillermo Javier Rosa-Diez
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	glomerular filtration rate chronic kidney disease MDRD study equation CKD-EPI equation cystatin C creatinine clearance Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b80d95d6d03446d894fb755a415e57df
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spelling	oai:doaj.org-article:b80d95d6d03446d894fb755a415e57df2021-12-02T14:58:04ZThe Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool2296-858X10.3389/fmed.2021.769335https://doaj.org/article/b80d95d6d03446d894fb755a415e57df2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.769335/fullhttps://doaj.org/toc/2296-858XThe prevalence of chronic kidney disease (CKD) continues to increase worldwide, as well as the associated morbidity and mortality and the consequences on the patients' quality of life and countries' economies. CKD often evolves without being recognized by patients and physicians, although the diagnosis is based on two simple laboratory data: the estimated glomerular filtration rate (eGFR) and urine analysis. To measure GFR, the knowledge about the physiologic processes at the nephron level, the concept of clearance, and the identification of creatinine as a suitable endogenous marker for measuring the creatinine clearance (CrCl) had to be previously developed. On those bases, different equations to calculate CrCl (Cockcroft and Gault, 1976), or estimated GFR (four variables MDRD, 1999; CKD-Epi, 2009, among others) were generated. They all include creatinine and some demographic data, such as sex and age. However, to compare results throughout life or among laboratories, the creatinine determination must be standardized. In addition, the accuracy of these equations remains controversial in certain subgroups of patients. For these reasons, other mathematical models to improve CrCl estimation have been developed, such as when urine cannot be collected, in debilitated elderly patients and patients with trauma, diabetes, or obesity. Currently, eGFR in adults can be measured and reported immediately, using isotope dilution mass spectrometry traceable creatinine-based equations. In conclusion, based on knowledge obtained from renal physiology, eGFR can be used in the clinic for the diagnosis and early treatment of CKD, as well as a public instrument to estimate the prevalence.Ana Maria CusumanoCarmen Tzanno-MartinsGuillermo Javier Rosa-DiezFrontiers Media S.A.articleglomerular filtration ratechronic kidney diseaseMDRD study equationCKD-EPI equationcystatin Ccreatinine clearanceMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	glomerular filtration rate chronic kidney disease MDRD study equation CKD-EPI equation cystatin C creatinine clearance Medicine (General) R5-920
spellingShingle	glomerular filtration rate chronic kidney disease MDRD study equation CKD-EPI equation cystatin C creatinine clearance Medicine (General) R5-920 Ana Maria Cusumano Carmen Tzanno-Martins Guillermo Javier Rosa-Diez The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool
description	The prevalence of chronic kidney disease (CKD) continues to increase worldwide, as well as the associated morbidity and mortality and the consequences on the patients' quality of life and countries' economies. CKD often evolves without being recognized by patients and physicians, although the diagnosis is based on two simple laboratory data: the estimated glomerular filtration rate (eGFR) and urine analysis. To measure GFR, the knowledge about the physiologic processes at the nephron level, the concept of clearance, and the identification of creatinine as a suitable endogenous marker for measuring the creatinine clearance (CrCl) had to be previously developed. On those bases, different equations to calculate CrCl (Cockcroft and Gault, 1976), or estimated GFR (four variables MDRD, 1999; CKD-Epi, 2009, among others) were generated. They all include creatinine and some demographic data, such as sex and age. However, to compare results throughout life or among laboratories, the creatinine determination must be standardized. In addition, the accuracy of these equations remains controversial in certain subgroups of patients. For these reasons, other mathematical models to improve CrCl estimation have been developed, such as when urine cannot be collected, in debilitated elderly patients and patients with trauma, diabetes, or obesity. Currently, eGFR in adults can be measured and reported immediately, using isotope dilution mass spectrometry traceable creatinine-based equations. In conclusion, based on knowledge obtained from renal physiology, eGFR can be used in the clinic for the diagnosis and early treatment of CKD, as well as a public instrument to estimate the prevalence.
format	article
author	Ana Maria Cusumano Carmen Tzanno-Martins Guillermo Javier Rosa-Diez
author_facet	Ana Maria Cusumano Carmen Tzanno-Martins Guillermo Javier Rosa-Diez
author_sort	Ana Maria Cusumano
title	The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool
title_short	The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool
title_full	The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool
title_fullStr	The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool
title_full_unstemmed	The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool
title_sort	glomerular filtration rate: from the diagnosis of kidney function to a public health tool
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b80d95d6d03446d894fb755a415e57df
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The Glomerular Filtration Rate: From the Diagnosis of Kidney Function to a Public Health Tool

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