Comparative Assessment Of Creatinine-based Estimates Of Renal Function In Health And Disease
Guide By :
Dr. Manisha Mandal
Degree :
College :
MGM Medical College & LSK Hospital, Kishanganj, Bihar-855107
Precise measurement of renal function is imperative for the diagnosis and management of kidney disease. The estimation of glomerular filtration rate (GFR) are based upon prediction equations derived from chronic kidney disease (CKD) cases. The present study was carried out to investigate the status of renal function in 196 healthy adults without kidney disease using creatinine-based CKD-EPI and MDRD2 prediction equations. The mean ±SD GFR (≥90 and <90 respectively) was 106.81±1.08 ml/min per 1.73 m2 and 75.81±0.97 ml/min per 1.73 m2 by CKD-EPI while by MDRD2 the mean ±SD GFR (≥90 and <90 respectively) was 107.24±2.13 ml/min per 1.73 m2 and 72.29±0.85 ml/min per 1.73 m2; the serum creatinine level in all was within normal reference range. There was a combination of both normal and CKD stage 2 with GFR levels >60 ml/min per 1.73 m2 in all the age groups by both the CKD-EPI and MDRD2 estimates, while MDRD2 predicted stage 3A CKD with GFR within 45-59 ml/min per 1.73 m2 in subjects above 40 years. The normal serum creatinine reference interval does not necessarily reflect a nor
Serum creatinine (SCr) is considered as an indicator of renal function in many different clinical settings; however the normal SCr reference interval does not necessarily reflect a normal renal function for a patient as its level will not be elevated until 60% damage of the kidney has occurred. Moreover, the SCr level is also affected by factors like creatinine glomerular filtration, nutrition, muscle mass, age, gender, race, body size, renal secretion, kidney dysfunction, colorimetric interference, and inter assay differences. Hence, the more accurate Glomerular filtration rate (GFR), is universally used as an index of renal function in health and disease. There are various methods for the estimation of GFR. Direct GFR measurement using exogenous filtration markers, and tracers on large number of patients is time-consuming, impractical, expensive, and hence is not routinely applied in common practice. The conventional method of estimating GFR by the assessment of creatinine clearance measured from 24-hour urine collections is also cumbersome and is likely to have collection errors. These limitations have been overcome by the introduction of several equations for the estimation of GFR from the SCr concentration adjusted for various demographic features, of which, the CKD-EPI and MDRD2 equations are the most widely recommended and used formulas.
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