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Module 1: Understanding Chronic Kidney Disease (ckd)Use eGFR to assess and monitor kidney function
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səhifə | 9/18 | tarix | 25.05.2022 | ölçüsü | 2,76 Mb. | | #87833 |
| Diet Module 1 2019 - The eGFR is the estimated glomerular filtration rate.
- The eGFR provides an estimate of how much plasma is filtered by the kidneys each minute.
What is the glomerular filtration rate (GFR)? - GFR is equal to the sum of the filtration rates in all of the functioning nephrons.
- GFR is not routinely measured in clinical settings.
- Estimation of the GFR (eGFR), using serum creatinine level, gives a rough measure of the number of functioning nephrons.
What is the GFR? - Cardiac output (CO) = 6 L/min
- X 20% of CO goes to kidneys = 1.2 L/min
- X Plasma is 50% blood volume = 600 mL/min
- X Filtration Fraction of 20% = 120 mL/min
- eGFR is not the measured GFR.
- eGFR estimates the measured GFR.
- The eGFR is a good estimate of the risk of having decreased kidney function.
- Like other risk predictors, when it is the solitary indicator, it should be used cautiously, especially when “diagnosing” disease.
- The Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology (CKD-EPI) equations are most widely used for estimating GFR.
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- The variables include serum creatinine (Scr), age, race, and gender.
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- MDRD eGFR = 175 x (Scr) -1.154 x (age) -0.203 x (0.742 if female) x (1.212 if African American)
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- CKD-EPI eGFR = 141 × min (Scr /κ,1)a × max (Scr /κ,1) -1.209 × 0.993 age × (1.018 if female) × (1.180 if African American)
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- The estimate is normalized to body surface area.
- References: Levey et al. Ann Intern Med. 1999; 130:461–470;
- Levey et al. Ann Intern Med. 2009:150:604–612.
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