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Assessment of kidney function : clinical indications for measured GFR

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dc.contributor.author Ebert, Natalie
dc.contributor.author Bevc, Sebastjan
dc.contributor.author Bökenkamp, Arend
dc.contributor.author Gaillard, Francois
dc.contributor.author Hornum, Mads
dc.contributor.author Jager, Kitty J.
dc.contributor.author Mariat, Christophe
dc.contributor.author Eriksen, Bjørn Odvar
dc.contributor.author Palsson, Runolfur
dc.contributor.author Rule, Andrew D.
dc.contributor.author van Londen, Marco
dc.contributor.author White, Christine
dc.contributor.author Schaeffner, Elke
dc.date.accessioned 2023-02-16T01:04:39Z
dc.date.available 2023-02-16T01:04:39Z
dc.date.issued 2021-08-01
dc.identifier.citation Ebert , N , Bevc , S , Bökenkamp , A , Gaillard , F , Hornum , M , Jager , K J , Mariat , C , Eriksen , B O , Palsson , R , Rule , A D , van Londen , M , White , C & Schaeffner , E 2021 , ' Assessment of kidney function : clinical indications for measured GFR ' , Clinical Kidney Journal , vol. 14 , no. 8 , pp. 1861-1870 . https://doi.org/10.1093/ckj/sfab042
dc.identifier.issn 2048-8505
dc.identifier.other 70335101
dc.identifier.other 45399468-5974-4891-90c1-9380d41ae334
dc.identifier.other 85110544111
dc.identifier.uri https://hdl.handle.net/20.500.11815/3991
dc.description We acknowledge support from the German Research Foundation (DFG) and the Open Access Publication Fund of Charite´– Universitätsmedizin Berlin. Publisher Copyright: © The Author(s) 2021.
dc.description.abstract In the vast majority of cases, glomerular filtration rate (GFR) is estimated using serum creatinine, which is highly influenced by age, sex, muscle mass, body composition, severe chronic illness and many other factors. This often leads to misclassification of patients or potentially puts patients at risk for inappropriate clinical decisions. Possible solutions are the use of cystatin C as an alternative endogenous marker or performing direct measurement of GFR using an exogenous marker such as iohexol. The purpose of this review is to highlight clinical scenarios and conditions such as extreme body composition, Black race, disagreement between creatinine- and cystatin C-based estimated GFR (eGFR), drug dosing, liver cirrhosis, advanced chronic kidney disease and the transition to kidney replacement therapy, non-kidney solid organ transplant recipients and living kidney donors where creatinine-based GFR estimation may be invalid. In contrast to the majority of literature on measured GFR (mGFR), this review does not include aspects of mGFR for research or public health settings but aims to reach practicing clinicians and raise their understanding of the substantial limitations of creatinine. While including cystatin C as a renal biomarker in GFR estimating equations has been shown to increase the accuracy of the GFR estimate, there are also limitations to eGFR based on cystatin C alone or the combination of creatinine and cystatin C in the clinical scenarios described above that can be overcome by measuring GFR with an exogenous marker. We acknowledge that mGFR is not readily available in many centres but hope that this review will highlight and promote the expansion of kidney function diagnostics using standardized mGFR procedures as an important milestone towards more accurate and personalized medicine.
dc.format.extent 10
dc.format.extent 650279
dc.format.extent 1861-1870
dc.language.iso en
dc.relation.ispartofseries Clinical Kidney Journal; 14(8)
dc.rights info:eu-repo/semantics/openAccess
dc.subject biomarker
dc.subject chronic kidney disease
dc.subject clinical indications
dc.subject creatinine
dc.subject cystatin C
dc.subject kidney function
dc.subject measured glomerular filtration rate
dc.subject Nephrology
dc.subject Transplantation
dc.title Assessment of kidney function : clinical indications for measured GFR
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/systematicreview
dc.description.version Peer reviewed
dc.identifier.doi 10.1093/ckj/sfab042
dc.relation.url http://www.scopus.com/inward/record.url?scp=85110544111&partnerID=8YFLogxK
dc.contributor.department Faculty of Medicine
dc.contributor.department Office of Division of Clinical Services I

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