David Johnson1, Tim Usherwood. 1. University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland. david_johnson@health.qld.gov.au
Abstract
BACKGROUND: Serum creatinine concentration is an unreliable and insensitive marker of chronic kidney disease (CKD). To improve CKD detection, Australasian guidelines have recently recommended that laboratories calculate and report an estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula with every request for serum creatinine concentration. OBJECTIVE: This articles aims to provide timely information to health professionals about how to appropriately interpret and act upon eGFR reports. It also discusses the treatments shown to reduce renal and cardiovascular risk in CKD patients, and the indications for nephrologist referral. DISCUSSION: The accuracy and precision of eGFRs are reasonable in most adults in whom calculated values are ENTITY lt 60 mL/min/1.73 m2. However, eGFRs should be interpreted with caution in some settings (particularly patients with eGFRs ENTITY gt 60 mL/min/1.73 m2 and children). Automatic laboratory reporting of eGFR will enhance early detection of CKD, allow the timely institution of appropriate reno- and cardio-protective therapies, and better inform decisions regarding the prescription of renally excreted medications.
BACKGROUND: Serum creatinine concentration is an unreliable and insensitive marker of chronic kidney disease (CKD). To improve CKD detection, Australasian guidelines have recently recommended that laboratories calculate and report an estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula with every request for serum creatinine concentration. OBJECTIVE: This articles aims to provide timely information to health professionals about how to appropriately interpret and act upon eGFR reports. It also discusses the treatments shown to reduce renal and cardiovascular risk in CKDpatients, and the indications for nephrologist referral. DISCUSSION: The accuracy and precision of eGFRs are reasonable in most adults in whom calculated values are ENTITY lt 60 mL/min/1.73 m2. However, eGFRs should be interpreted with caution in some settings (particularly patients with eGFRs ENTITY gt 60 mL/min/1.73 m2 and children). Automatic laboratory reporting of eGFR will enhance early detection of CKD, allow the timely institution of appropriate reno- and cardio-protective therapies, and better inform decisions regarding the prescription of renally excreted medications.
Authors: Daniel Gero; Fadia Dib; Maurice Matter; Manuel Pascual; Jean-Pierre Venetz; Nicolas Demartines; Emmanuel Melloul Journal: World J Surg Date: 2017-11 Impact factor: 3.352