Real-time Measurement of Glomerular Filtration Rate

Abstract

Richard Solomon

Glomerular filtration rate (GFR) is the most widely used metric of kidney function. The search for an ideal marker of glomerular filtration was ultimately resolved by Homer Smith and his colleagues with the introduction of inulin (1). 

 

• To understand the inherent inaccuracies in the GFR estimating equations.
• To be able to identify when misclassification of a patient’s stage of CKD could influence therapeutic and diagnostic decisions.

 

To be able to identify non-steady state conditions and use novel diagnostic measures to identify early changes in GFR.

Estimating equations lack precision

Increase in misclassification

May not apply to all populations, ethnic groups, age ranges, etc.

Only valid for the populations used in deriving the equations

Need multiple equations

Can’t be used in the non-steady state (acute kidney injury)

Short comings of an estimated GFR?

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