Adventures with Creatinine and eGFR - A National, International and Personal Story - AACB Roman Lecture 2014.

In Australia and New Zealand today there is a commonality in all laboratories in many areas of testing related to Chronic Kidney Disease (CKD). These include creatinine assay standardisation, estimated Glomerular Filtration Rate (eGFR) reporting and the use of common units for serum creatinine and eGFR. This is supported by a single definition for diagnosis and staging of CKD, agreed indications for who and how to test together with detailed advice on test interpretation and patient management provided by our nephrology colleagues. These outcomes are the product of a decade of effort within Australia and New Zealand with collaboration between clinical disciplines and amongst laboratories. These local activities have been based on and supported by international actions in assay standardisation, eGFR formula development, understanding of clinical outcomes and guideline development. It is my belief that the local implementation of the current laboratory-based CKD testing processes is an outstanding example of good laboratory practice. This paper outlines the local and international activities and provides a view of my personal adventures with creatinine and eGFR.