How to measure renal function in clinical practice: Age affects estimated glomerular filtration rate

doi:10.1136/bmj.333.7574.918

BMJ 2006;333:918 (28 October), doi:10.1136/bmj.333.7574.918

Letter

How to measure renal function in clinical practice

Age affects estimated glomerular filtration rate

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

EDITOR—I read the overview by Traynor et al regardinghow to measure renal function.¹ Especially for primary caredoctors, an abnormal estimated glomerular filtration rate inpatients older than 70 may be normal and estimates below anMDRD (modification of diet in renal disease) estimated glomerularfiltration rate of < 60 ml/min/1.73 m² (despite a normalserum creatinine) are not validated by the MDRD equation.²

Patients older than 40 generally lose between 0.8-1 ml/min ofglomerular filtration rate per year due to nephron loss as anormal ageing process.³ Hence one cannot assume that an estimatedglomerular filtration rate of less than 60 ml/min/1.73 m² isindicative of chronic kidney disease in elderly patients. Higherrates of loss (> 4 ml/min/1.73 m²) would be suggestive ofprogressive chronic kidney disease or precipitating factorssuch as hypertension. Hence an 80 year old may be normally expectedto have . . . [Full text of this article]

Sunil Bhandari, consultant nephrologist

Hull and East Yorkshire Hospital NHS Trust sunil.bhandari@hey.nhs.uk

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MacGregor, M. S (2006). How to measure renal function in clinical practice: Stage 3 chronic kidney disease is not a consequence of normal ageing. BMJ 333: 1072-1072 [Full text]