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

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