How to measure renal function in clinical practice

doi:10.1136/bmj.38975.390370.7C

BMJ 2006;333:733-737 (7 October), doi:10.1136/bmj.38975.390370.7C

Clinical review

How to measure renal function in clinical practice

Jamie Traynor, specialist registrar¹, Robert Mactier, consultant nephrologist², Colin C Geddes, consultant nephrologist¹, Jonathan G Fox, consultant nephrologist²

¹ Renal Unit, Western Infirmary, Glasgow G11 6NT, ² Renal Unit, Glasgow Royal Infirmary

Correspondence to: J Traynor jamie.traynor@northglasgow.scot.nhs.uk

The first 150 words of the full text of this article appear below.

Introduction

The reliable measurement of renal excretory function is of greatimportance in clinical practice and in research. The introductionof routine reporting of estimated glomerular filtration rateand a new definition of chronic kidney disease has renewed interestin methods of measuring renal function. Coupled with this isthe fact that several countries are moving towards populationscreening for renal impairment to try to reduce the associatedincreased cardiovascular risk. Accurate measurement is methodologicallydifficult so surrogate measures such as serum creatinine levelsand prediction formulas (based on factors such as the patient'sage, sex, and serum creatinine level) are more commonly usedin routine practice. We describe routine and more specialisedmethods of assessing renal function and discuss estimated glomerularfiltration rate.

The kidney has several interlinked functions (box). These dependon glomerular filtration rate, the unit measure of kidney function.Glomerular filtration rate can be defined as the . . . [Full text of this article]

Creatinine

Creatinine clearance

Urea

Mean of urea and creatinine clearance

Inulin clearance

Radioisotopic methods

Radiocontrast agents

Cystatin C

Prediction formulas

Cockcroft and Gault equation

Modification of diet in renal disease formula

Conclusion

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Formula estimation of glomerular filtration rate: have we gone wrong?: Paul D Giles and David A Fitzmaurice
BMJ 2007 334: 1198-1200. [Extract] [Full Text] [PDF]

How to measure renal function in clinical practice: Eating cooked meat alters serum creatinine concentration and eGFR significantly: David J Preiss, Ian M Godber, and Ian R Gunn
BMJ 2006 333: 1072. [Extract] [Full Text] [PDF]

How to measure renal function in clinical practice: Age affects estimated glomerular filtration rate: Sunil Bhandari
BMJ 2006 333: 918. [Extract] [Full Text]

How to measure renal function in clinical practice: Estimated glomerular filtration rate in general practice: Jo Richardson
BMJ 2006 333: 918. [Extract] [Full Text]

This article has been cited by other articles:

Stevens, K.K., Woo, Y.M., Rodger, R.S.C., Geddes, C.C. (2009). Discharging patients from the nephrology clinic to primary care--will they get appropriate monitoring of renal function?. QJM 102: 425-428 [Abstract] [Full text]
Brueckner, D., Brueckner, M. (2009). Impaired estimated glomerular filtration rate associated with hypothyroidism. Does it really mean an acute renal failure?. BMJ Case Reports 2009: bcr0920080848-bcr0920080848 [Abstract] [Full text]
Kremmyda, A, Neithercut, W D (2009). A review of eGFR reporting after 6 months in practice. J. Clin. Pathol. 62: 345-349 [Abstract] [Full text]
Tosi, P., Barosi, G., Lazzaro, C., Liso, V., Marchetti, M., Morra, E., Pession, A., Rosti, G., Santoro, A., Zinzani, P. L., Tura, S. (2008). Consensus conference on the management of tumor lysis syndrome. haematol 93: 1877-1885 [Abstract] [Full text]
Graves, J. W. (2008). Diagnosis and Management of Chronic Kidney Disease. Mayo Clin Proc. 83: 1064-1069 [Abstract] [Full text]
Almond, A., Siddiqui, S., Robertson, S., Norrie, J., Isles, C. (2008). Comparison of combined urea and creatinine clearance and prediction equations as measures of residual renal function when GFR is low. QJM 101: 619-624 [Abstract] [Full text]
Geddes, C C, Baxter, G M (2008). Renal impairment. Imaging 20: 1-19 [Abstract] [Full text]
Quinn, M. P., Rainey, A., Cairns, K. J., Marshall, A. H., Savage, G., Kee, F., Peter Maxwell, A., Reaney, E., Fogarty, D. G. (2008). The practical implications of using standardized estimation equations in calculating the prevalence of chronic kidney disease. Nephrol Dial Transplant 23: 542-548 [Abstract] [Full text]
Glynn, L. G., Reddan, D., Newell, J., Hinde, J., Buckley, B., Murphy, A. W. (2007). Chronic kidney disease and mortality and morbidity among patients with established cardiovascular disease: a West of Ireland community-based cohort study. Nephrol Dial Transplant 22: 2586-2594 [Abstract] [Full text]
Giles, P. D, Fitzmaurice, D. A (2007). Formula estimation of glomerular filtration rate: have we gone wrong?. BMJ 334: 1198-1200 [Full text]
Preiss, D. J, Godber, I. M, Gunn, I. R (2006). How to measure renal function in clinical practice: Eating cooked meat alters serum creatinine concentration and eGFR significantly. BMJ 333: 1072-1072 [Full text]
Bhandari, S. (2006). How to measure renal function in clinical practice: age affects estimated glomerular filtration rate.. BMJ 333: 918-918 [Full text]
Richardson, J. (2006). How to measure renal function in clinical practice: estimated glomerular filtration rate in general practice.. BMJ 333: 918-918 [Full text]

Rapid Responses:

Read all Rapid Responses

Renal Function and Age a brief comment: Sunil Bhandari
bmj.com, 10 Oct 2006 [Full text]
Urea and creatinine: simple, cheap and have many uses: Amit Patel
bmj.com, 11 Oct 2006 [Full text]
Measures of Renal Function: Andy Bow, et al.
bmj.com, 11 Oct 2006 [Full text]
eGFR in general practice: Jo Richardson
bmj.com, 16 Oct 2006 [Full text]
Estimating renal function using the MDRD-equation � all that simple?: Michiel F Schreuder, et al.
bmj.com, 17 Oct 2006 [Full text]
The measurement of renal function in clinical practice: David G Beevers
bmj.com, 24 Oct 2006 [Full text]
Do not stop ACEI/ ARAs unless clear contraindications present: Ramaswamy Diwakar, et al.
bmj.com, 21 Oct 2006 [Full text]
Time to also change serum creatinine reference value reporting?: Uptal D Patel
bmj.com, 25 Oct 2006 [Full text]
Cystatin C level: potential new gold-standard for renal function in critically ill patients?: Annick A.N.M. Royakkers, et al.
bmj.com, 26 Oct 2006 [Full text]
Eating cooked meat alters serum creatinine concentration and eGFR significantly: David J Preiss, et al.
bmj.com, 8 Nov 2006 [Full text]
Re: Eating cooked meat alters serum creatinine concentration and eGFR significantly: JK Anand
bmj.com, 8 Nov 2006 [Full text]
Re: Re: Eating cooked meat alters serum creatinine concentration and eGFR significantly: David J Preiss, et al.
bmj.com, 9 Nov 2006 [Full text]
The MDRD-formula in pregnancy: Friso MC Delemarre, et al.
bmj.com, 5 Dec 2006 [Full text]