Challenges in Measuring Glomerular Filtration Rate: A Clinical Laboratory Perspective

Jesse C. Seegmiller, John H. Eckfeldt, John C Lieske

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

The assessment of kidney function is a cornerstone in the clinical management and health of the patient. Although the kidneys perform many physiologic functions and are essential for maintaining homeostasis, kidney function is typically evaluated, quantitated, and understood using the glomerular filtration rate (GFR). Although GFR can be directly measured using a variety of externally administered glomerular filtration markers, in general practice, the GFR is usually estimated (eGFR) using endogenous markers that are cleared primarily by kidney filtration. Common situations exist where the GFR needs to be measured (mGFR) in order to proceed with care. This manuscript will review laboratory challenges in the assessment of GFR. Key points to consider when implementing a mGFR testing protocol are the following: marker selection, clearance methodology (urinary vs solely plasma measurements of filtration marker), sample collection, number of samples to collect, staff required, and analytical measurement technology for the filtration marker selected. We suggest those wanting to implement mGFR testing examine site-specific institutional resources along with patient population and proceed with the approaches best suited for their clinical needs and laboratory resources available.

Original languageEnglish (US)
Pages (from-to)93-104
Number of pages12
JournalAdvances in Chronic Kidney Disease
Volume25
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Glomerular Filtration Rate
Kidney
General Practice
Homeostasis
Technology
Health
Population

Keywords

  • Creatinine
  • Cystatin C
  • Glomerular filtration rate
  • Iohexol
  • Iothalamate

ASJC Scopus subject areas

  • Nephrology

Cite this

Challenges in Measuring Glomerular Filtration Rate : A Clinical Laboratory Perspective. / Seegmiller, Jesse C.; Eckfeldt, John H.; Lieske, John C.

In: Advances in Chronic Kidney Disease, Vol. 25, No. 1, 01.01.2018, p. 93-104.

Research output: Contribution to journalReview article

@article{3434610a91cc407b9519e4b63d1bf97f,
title = "Challenges in Measuring Glomerular Filtration Rate: A Clinical Laboratory Perspective",
abstract = "The assessment of kidney function is a cornerstone in the clinical management and health of the patient. Although the kidneys perform many physiologic functions and are essential for maintaining homeostasis, kidney function is typically evaluated, quantitated, and understood using the glomerular filtration rate (GFR). Although GFR can be directly measured using a variety of externally administered glomerular filtration markers, in general practice, the GFR is usually estimated (eGFR) using endogenous markers that are cleared primarily by kidney filtration. Common situations exist where the GFR needs to be measured (mGFR) in order to proceed with care. This manuscript will review laboratory challenges in the assessment of GFR. Key points to consider when implementing a mGFR testing protocol are the following: marker selection, clearance methodology (urinary vs solely plasma measurements of filtration marker), sample collection, number of samples to collect, staff required, and analytical measurement technology for the filtration marker selected. We suggest those wanting to implement mGFR testing examine site-specific institutional resources along with patient population and proceed with the approaches best suited for their clinical needs and laboratory resources available.",
keywords = "Creatinine, Cystatin C, Glomerular filtration rate, Iohexol, Iothalamate",
author = "Seegmiller, {Jesse C.} and Eckfeldt, {John H.} and Lieske, {John C}",
year = "2018",
month = "1",
day = "1",
doi = "10.1053/j.ackd.2017.10.006",
language = "English (US)",
volume = "25",
pages = "93--104",
journal = "Advances in Chronic Kidney Disease",
issn = "1548-5595",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Challenges in Measuring Glomerular Filtration Rate

T2 - A Clinical Laboratory Perspective

AU - Seegmiller, Jesse C.

AU - Eckfeldt, John H.

AU - Lieske, John C

PY - 2018/1/1

Y1 - 2018/1/1

N2 - The assessment of kidney function is a cornerstone in the clinical management and health of the patient. Although the kidneys perform many physiologic functions and are essential for maintaining homeostasis, kidney function is typically evaluated, quantitated, and understood using the glomerular filtration rate (GFR). Although GFR can be directly measured using a variety of externally administered glomerular filtration markers, in general practice, the GFR is usually estimated (eGFR) using endogenous markers that are cleared primarily by kidney filtration. Common situations exist where the GFR needs to be measured (mGFR) in order to proceed with care. This manuscript will review laboratory challenges in the assessment of GFR. Key points to consider when implementing a mGFR testing protocol are the following: marker selection, clearance methodology (urinary vs solely plasma measurements of filtration marker), sample collection, number of samples to collect, staff required, and analytical measurement technology for the filtration marker selected. We suggest those wanting to implement mGFR testing examine site-specific institutional resources along with patient population and proceed with the approaches best suited for their clinical needs and laboratory resources available.

AB - The assessment of kidney function is a cornerstone in the clinical management and health of the patient. Although the kidneys perform many physiologic functions and are essential for maintaining homeostasis, kidney function is typically evaluated, quantitated, and understood using the glomerular filtration rate (GFR). Although GFR can be directly measured using a variety of externally administered glomerular filtration markers, in general practice, the GFR is usually estimated (eGFR) using endogenous markers that are cleared primarily by kidney filtration. Common situations exist where the GFR needs to be measured (mGFR) in order to proceed with care. This manuscript will review laboratory challenges in the assessment of GFR. Key points to consider when implementing a mGFR testing protocol are the following: marker selection, clearance methodology (urinary vs solely plasma measurements of filtration marker), sample collection, number of samples to collect, staff required, and analytical measurement technology for the filtration marker selected. We suggest those wanting to implement mGFR testing examine site-specific institutional resources along with patient population and proceed with the approaches best suited for their clinical needs and laboratory resources available.

KW - Creatinine

KW - Cystatin C

KW - Glomerular filtration rate

KW - Iohexol

KW - Iothalamate

UR - http://www.scopus.com/inward/record.url?scp=85042782777&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042782777&partnerID=8YFLogxK

U2 - 10.1053/j.ackd.2017.10.006

DO - 10.1053/j.ackd.2017.10.006

M3 - Review article

C2 - 29499892

AN - SCOPUS:85042782777

VL - 25

SP - 93

EP - 104

JO - Advances in Chronic Kidney Disease

JF - Advances in Chronic Kidney Disease

SN - 1548-5595

IS - 1

ER -