| Theme | Considering the timing of chronic dialysis (renal replacement therapy) initiation | |
|---|---|---|
| Title | Pitfalls of evaluating renal function for renal replacement therapy among CKD G5 patients | |
| Publish Date | 2012/12 | |
| Author | Yoshinari Yasuda | Department of CKD Initiatives, Internal Medicine, Graduate School of Medicine, Nagoya University |
| Author | Seiichi Matsuo | 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 but it is complicated and expensive. Thus, in most cases, GFR is evaluated by eGFR equations or creatinine clearance (Ccr). Errors between measured GFR and eGFR or Ccr tend to be greater in patients with severe renal dysfunction. Cystatin-C (Cys-C) is a promising GFR marker which is not effected by body mass, but it does not provide adequate evaluation of patients with low GFR. However, Cys-C based GFR equation developed by the Japanese Society of Nephrology could be applicable in low GFR cases, because non-renal clearance of Cys-C is involved in the equation. For appropriate evaluation of renal function, it is important to consider possible errors in GFR equations and Ccr. | |