The Japanese Journal of Clinical Dialysis Vol.28 No.10(1-2)

Theme Outcomes of CKD Campaign and Future Treatments Concerning CKD and Dialysis
Title Pitfalls in evaluating renal function by GFR equations
Publish Date 2012/09
Author Yoshinari Yasuda Department of CKD Initiatives, Internal Medicine, Graduate School of Medicine, Nagoya University
Author Shoichi Maruyama Department of Nephrology, Internal Medicine, Graduate School of Medicine, Nagoya University
[ Summary ] Renal function should be assessed by glomerular filtration rate (GFR). Inulin clearance (Cin) is the gold standard for GFR measurement. However, it is complicated and expensive. Thus, in daily practice, GFR is evaluated by eGFR equation. More accurately, renal function could be examined by creatinine clearance (Ccr) or Cin. But adequate urine collection is essential to achieve reliable results. Estimated GFR (eGFR) is calculated by serum creatinine (Cr) levels, age and gender. Since Cr is affected by body muscle mass, eGFR values tend to be inaccurate in patients with either large or small levels of muscle mass. Cystatin-C (Cys-C) is a promising GFR marker, which is not affected by body size. A new GFR equation based on Cys-C has been produced by the Japanese Society of Nephrology. For appropriate evaluation of renal function, nephrologists must understnad the positive and negative factors related to eGFRcreat and eGFRcys based assessment.
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