Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: a position statement

被引：125

作者：

Anavekar, N ^{[1
]}

Bais, R ^{[1
]}

Carney, S ^{[1
]}

Eris, J ^{[1
]}

Gallagher, M ^{[1
]}

Johnson, D ^{[1
]}

Jones, G ^{[1
]}

Sikaris, K ^{[1
]}

Lonergan, M ^{[1
]}

Ludlow, M ^{[1
]}

Mackie, J ^{[1
]}

Mathew, T ^{[1
]}

May, S ^{[1
]}

McBride, G ^{[1
]}

Meerkin, M ^{[1
]}

Peake, M ^{[1
]}

Power, D ^{[1
]}

Snelling, P ^{[1
]}

Voss, D ^{[1
]}

Walker, R ^{[1
]}

机构：

[1] Kidney Hlth Australia, Adelaide, SA 5006, Australia

来源：

MEDICAL JOURNAL OF AUSTRALIA | 2005年 / 183卷 / 03期

关键词：

D O I：

10.5694/j.1326-5377.2005.tb06958.x

中图分类号：

R5 [内科学];

学科分类号：

1002 [临床医学]; 100201 [内科学];

摘要：

The systematic staging of chronic kidney disease (CKD) by glomerular filtration measurement and proteinuria has allowed the development of rational and appropriate management plans. One of the barriers to early detection of CKD is the lack of a precise, reliable and consistent measure of kidney function. The most common measure of kidney function is currently serum creatinine concentration. It varies with age, sex, muscle mass and diet, and interlaboratory variation between measurements is as high as 20%. The reference interval for serum creatinine concentration includes up to 25% of people (particularly thin, elderly women) who have an estimated glomerular filtration rate (eGFR) that is significantly reduced (< 60mUmin/1.73m(2)). The recent publication of a validated formula (MDRD) to estimate GFR from age, sex, race and serum creatinine concentration, without any requirement for measures of body mass, allows pathology laboratories to "automatically" generate eGFR from data already acquired. Automatic laboratory reporting of eGFR calculated from serum creatinine measurements would help to identify asymptomatic kidney dysfunction at an earlier stage. eGFR correlates well with complications of CKD and an increased risk of adverse outcomes such as cardiovascular morbidity and mortality. We recommend that pathology laboratories automatically report eGFR each time a serum creatinine test is ordered in adults. As the accuracy of eGFR is suboptimal in patients with normal or near-normal renal function, we recommend that calculated eGFRs above 60mL/min/1.73m(2) be reported by laboratories as "> 60mL/min/1.73m(2)", rather than as a precise figure.

引用

页码：138 / +

页数：4

共 23 条

[1]

Detection of chronic kidney disease with laboratory reporting of estimated glomerular filtration rate and an educational program [J].