TY - JOUR
T1 - Estimating glomerular filtration rate
T2 - Is it good enough? and is it time to move on?
AU - Murphy, Daniel P.
AU - Hsu, Chi Yuan
PY - 2013/5
Y1 - 2013/5
N2 - Purpose of review: The aim is to examine a dominant narrative in nephrology over the past decade: that measured glomerular filtration rate (GFR) is the gold standard measure of kidney function; accurate assessment of GFR is critical and paramount; and further efforts to refine GFR estimation should continue. Recent findings: Studies that have simultaneously compared measured GFR and estimated GFR (using endogenous filtration markers such as creatinine, or newer ones such as cystatin C or β-trace protein) against some external metric of kidney function have failed to show that measured GFR is consistently superior, which is what one would expect if measured GFR were truly the 'gold standard.' Summary: Compared with estimated GFR, measured GFR does not consistently predict renal-related outcomes better. Clinical decision-making almost never requires precise and accurate knowledge of a patient's static GFR value. Efforts at perfecting cross-sectional estimates of GFR may have reached a point of diminishing returns.
AB - Purpose of review: The aim is to examine a dominant narrative in nephrology over the past decade: that measured glomerular filtration rate (GFR) is the gold standard measure of kidney function; accurate assessment of GFR is critical and paramount; and further efforts to refine GFR estimation should continue. Recent findings: Studies that have simultaneously compared measured GFR and estimated GFR (using endogenous filtration markers such as creatinine, or newer ones such as cystatin C or β-trace protein) against some external metric of kidney function have failed to show that measured GFR is consistently superior, which is what one would expect if measured GFR were truly the 'gold standard.' Summary: Compared with estimated GFR, measured GFR does not consistently predict renal-related outcomes better. Clinical decision-making almost never requires precise and accurate knowledge of a patient's static GFR value. Efforts at perfecting cross-sectional estimates of GFR may have reached a point of diminishing returns.
KW - Estimated glomerular filtration rate
KW - Glomerular filtration rate
KW - Measured glomerular filtration rate
KW - Relative utility
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U2 - 10.1097/MNH.0b013e32836041e4
DO - 10.1097/MNH.0b013e32836041e4
M3 - Review article
C2 - 23571811
AN - SCOPUS:84878868691
SN - 1062-4821
VL - 22
SP - 310
EP - 315
JO - Current opinion in nephrology and hypertension
JF - Current opinion in nephrology and hypertension
IS - 3
ER -