Measurement of Glomerular Filtration Rate by Exogenous and Endogenous Filtration Markers.
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Date
2015-04
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Abstract
The National Kidney Foundation (NKF), through its Kidney Disease Outcomes Quality Initiative
(K/DOQI), and other National institutions proposed glomerular filtration rate (GFR) to describe, classify, screen and
examine chronic kidney disease (CKD). GFR is the standard measure of renal function but cannot be practically
measured for clinical and research purposes, so serum creatinine (Scr) is used to calculate estimated GFR (eGFR)
which is affected by age, weight, muscle mass, race, various medications and extra-glomerular elimination. To
overcome this Cystatin C (CysC) is new and reliable marker for renal function due to its low molecular weight it is
freely filtered through glomerulus, completely reabsorbed and catabolized, but not secreted, by tubular cells. Various
equations used for GFR estimation such as the Modification of Diet in Renal Disease (MDRD) Study equation,
Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Cockcroft–Gault (CG) equation based on Scr ,
Grubb and Hoek equation based on CysC and Stevens equation based on both SCr and CysC are used. CKD–EPI is
preferred for identifying patients with CKD and for staging the disease. The risk of underestimation of kidney
function with MDRD is highest when the GFR is 30 mL/minute/1.73 m2 so GFR is calculated by CKD–EPI equation
for these persons. CKD–EPI is recommended for diagnosis and staging when the addition of appropriate
prophylactic drugs or avoidance of certain nephrotoxic drugs should occur.
The aim of this review is to evaluate from recent literature available different exogenous and endogenous markers
used for the determination of GFR and which marker found suitable for the determination of GFR according to
literature available on PubMed and determine their reliability in the detection and monitoring of CKD and its stages.
Key words: Glomerular filtration rate, chronic kidney disease, Creatinine, Cystatin C, Measurement of GFR
Abbreviations - Glomerular filtration rate (GFR), chronic kidney disease (CKD), Modification of Diet in Renal
Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Cockcroft–Gault (CG), Serum
creatinine (Scr), serum cystatin C (CysC), National Kidney Foundation’s Kidney Disease Outcomes Quality
Initiative (KDOQI), Cardiovascular disease (CVD), Food and drug administration (FDA), Diethylene triamine
pentaacetic acid (DTPA), Ethylene diamine tetra acetic acid (EDTA)
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Keywords
Glomerular filtration rate, chronic kidney disease, Creatinine, Cystatin C, Measurement of GFR
Citation
Patra P K, Amle Dnyanesh, Jain Achla. Measurement of Glomerular Filtration Rate by Exogenous and Endogenous Filtration Markers. International Journal of Applied Biology and Pharmaceutical Technology. 2015 Apr-June; 6(2): 7-15.