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Chronic kidney disease

Staging CKD: can we rely on estimated GFRs?

Including proteinuria in the NKF KDOQI staging system for chronic kidney disease will increase the accuracy of risk stratification, but will not improve the precision of glomerular filtration rate (GFR) estimation by prediction formulas. Using markers of glomerular filtration other than serum creatinine will hopefully enable implementation of novel formulas that more precisely estimate true GFR, especially in individuals with near-normal renal function.

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References

  1. Tonelli, M. et al. for the Alberta Kidney Disease Network. Using proteinuria and estimated glomerular filtration rate to classify risk in patients with chronic kidney disease: a cohort study. Ann. Intern. Med. 154, 12–21 (2011).

    Article  Google Scholar 

  2. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am. J. Kidney Dis. 39 (Suppl. 1), S1–S266 (2002).

  3. Astor, B. C. et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts. Kidney Int. doi:10.1038/ki.2010.550.

  4. Iseki, K., Kinjo, K., Iseki, C. & Takishita, S. Relationship between predicted creatinine clearance and proteinuria and the risk of developing ESRD in Okinawa, Japan. Am. J. Kidney Dis. 44, 806–814 (2004).

    Article  CAS  Google Scholar 

  5. Remuzzi, G., Benigni, A. & Remuzzi, A. Mechanisms of progression and regression of renal lesions of chronic nephropathies and diabetes. J. Clin. Invest. 116, 288–296 (2006).

    Article  CAS  Google Scholar 

  6. Levey, A. S. et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann. Intern. Med. 130, 461–470 (1999).

    Article  CAS  Google Scholar 

  7. Rule, A. D. et al. Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney disease. Ann. Intern. Med. 141, 929–937 (2004).

    Article  CAS  Google Scholar 

  8. Ruggenenti, P., Perna, A. & Remuzzi, G. Preventing microalbuminuria in type 2 diabetes. N. Engl. J. Med. 352, author reply 833–834 (2005).

    Article  Google Scholar 

  9. Gaspari, F., Perico, N. & Remuzzi, G. Application of newer clearance techniques for the determination of glomerular filtration rate. Curr. Opin. Nephrol. Hypertens. 7, 675–680 (1998).

    Article  CAS  Google Scholar 

  10. Porrini, E., Ruggenenti, P. & Remuzzi, G. for the BENEDICT and DEMAND Investigators. Glomerular hyperfiltration accelerates renal disease progression in type 2 diabetes [abstract]. American Society of Nephrology Renal Week F-PO1244 (2010).

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Correspondence to Giuseppe Remuzzi.

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Ruggenenti, P., Remuzzi, G. Staging CKD: can we rely on estimated GFRs?. Nat Rev Nephrol 7, 307–308 (2011). https://doi.org/10.1038/nrneph.2011.58

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