How to measure renal function in clinical practice

Traynor, Jamie P.; Mactier, Robert; Geddes, Colin C.; Fox, Jonathan G.

doi:10.1136/bmj.38975.390370.7c

Cited by 276 publications

(230 citation statements)

References 20 publications

(10 reference statements)

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“…GFR was estimated from the simplified Modification of Diet in Renal Disease (MDRD) formula [19,20]. Underexcretion of urate was defined as a urate clearance (ratio uUr/sUr) <6.0 ml min −1 1.73 m −2 [21].…”

Section: Methodsmentioning

confidence: 99%

Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously benzbromarone-treated gout patients

et al. 2007

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Section: Methodsmentioning

confidence: 99%

Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously benzbromarone-treated gout patients

et al. 2007

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“…Estimated GFR (glomerular filtration rate) was calculated using abbreviated MDRD equation. 11,12 Regular use of cardiovascular medication (at the time of the surgical procedure) including angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blocker (ARB), calcium channel blockers (CCB) and statins (HMG-CoA reductase inhibitors) was also recorded.…”

Section: Studied Parametersmentioning

confidence: 99%

Acute kidney injury in peripheral arterial surgery patients: a cohort study

Schiller¹,

Mihaescu²,

Timar³

et al. 2013

Renal Failure

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Purpose: The aim of the study was to evaluate the prevalence of acute kidney injury (AKI) in a cohort of surgically treated patients with peripheral artery disease (PAD) and its association with the short-term and long-term outcome. Materials and methods: We conducted a retrospective cohort study on all the consecutive PAD inpatients in 2008. Data on the patients' demographic characteristics, medical history, treatment, outcome and laboratory tests measurements were retrieved from the medical records. Results: We analyzed 166 patients (71.6% males, mean age 63.2 years AE SD 10.7 years) and found an AKI prevalence of 12.7%. The AKI patients' group had more chronic kidney disease (CKD) (23.8% vs. 6.2%, p ¼ 0.005), diabetes mellitus (DM) (61.9% vs. 33.1%, p ¼ 0.011) and a higher length of hospital stay (19.48 vs. 15.42 days, p ¼ 0.047). At one year, the mortality was 33.3% in the AKI group compared to 1.3% in non-AKI group, with a strong association between AKI and death (OR ¼ 35.7; 95%CI ¼ 6.7 to 189) and AKI and major cardiovascular events (OR ¼ 29

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“…However, a potential drawback is that timed collections are often incomplete and the collection process may be cumbersome for the patient. Therefore, they have been largely replaced by the prediction formulas discussed below (1,10,11,17). However, timed urine collections may still be of additional help in the assessment of renal function, especially in those with malnutrition or, the opposite, with increased body muscle mass, in which estimated GFR may respectively provide an over-and underestimation of ''true'' renal function (18,19).…”

Section: Creatinine Clearance: Timed Urine Collectionsmentioning

confidence: 99%

“…Also in patients with abnormalities of body composition, the Cockcroft-Gault formula may not be a reliable estimate of GFR because the increased weight may be largely dependent on an increase in fat mass. Whereas the use of the Cockcroft-Gault equation in the assessment of renal function has been largely replaced by the modified Modification of Diet in Renal Disease (MDRD) equation, it is still often used in drug prescription tables (17), with continuing discussion as to which one of the two should be used in the guidance of dose adjustment (24,25).…”

Section: Prediction Formula Based On Creatinine Cockcroft-gault Equationmentioning

confidence: 99%

“…This seems especially relevant for hospitalized patients with severely impaired renal function (mean GFR 18 mL/ min), in which the MDRD equations were found to overestimate eGFR by an average of 6.8 mL/min/ 1.73 m 2 (30), probably due to a reduced muscle mass in these patients. Moreover, the MDRD formula may also not yield reliable results in patients with significant abnormalities of body composition (17). However, in general, the modified MDRD equation has largely replaced other methods in the routine assessment of renal function, and may also be used as an initial method to identify patients at risk for NSF or contrast nephropathy.…”

Section: Mdrd Equationmentioning

confidence: 99%

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Estimation of renal function in patients with chronic kidney disease

Kooman

2009

Magnetic Resonance Imaging

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The risk of nephrogenic systemic fibrosis after gadolinium exposure is inversely related to renal function. Various methods are available to assess the glomerular filtration rate (GFR). Prediction formulas based on serum creatinine, such as the abbreviated Modification of Diet in Renal Disease (MDRD) formula, are most commonly used and appear acceptable for clinical purposes in the majority of patients with chronic renal failure. However, especially in patients at the extremes of body composition, the results from creatinine‐based equations should be interpreted with caution. In those patients, additional methods, such as timed urine collections, predictions based on cystatin, single‐shot radiotracer methods, or, optimally, inulin clearance could be considered. In this review, the strengths and limitations of different methods to assess GFR are discussed. Apart from inulin clearance, no method can be considered the gold standard in the assessment of GFR. In cases of doubt, the decision to use gadolinium‐enhanced magnetic resonance imaging should always be based on clinical risk–benefit judgment. J. Magn. Reson. Imaging 2009;30:1341–1346. © 2009 Wiley‐Liss, Inc.

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How to measure renal function in clinical practice

Cited by 276 publications

References 20 publications

Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously benzbromarone-treated gout patients

Biochemical effectiveness of allopurinol and allopurinol-probenecid in previously benzbromarone-treated gout patients

Acute kidney injury in peripheral arterial surgery patients: a cohort study

Estimation of renal function in patients with chronic kidney disease

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