Recommendation of Czech Society of Nephrology of clinic biochemistry for examination of glomerular filtration
Abstract
Glomerular filtration rate (GF) is one of the basic methods of functional renal examination. where the degree of GF removal cannot be used as a classification mark for the degree of severity of kidney damage. At present, it is possible to use the GF method with direct determination based on the Rehbergr control principle or a calculation method that can be calculated from the value of serum creatinine and other variables (age, weight, urea, albumin, friend, race, etc.).
The wedge can be obtained with the truest GF value, without the possibility of crossing the GF limit; the Grubba equation is used to calculate GF from the serum cystatin C dose. Try all calculations of methods of estimating glomerular filtration rate (eGF) is performed without collecting urine.
Accurate urine collection is the largest source of errors in routine determinations. Another possible mistake is the inaccurate determination of creatinine, which affects muscle mass, nutrition and the presence of Jaffé positive chromogens (eg Glucose, ascorbic acid, uric acid, acetate, pyruvate).
To ensure an appropriate quality of eGF calculation, it is recommended that methods that are recalibrated to the ID-MS reference method be used to determine creative results. These methods are possible only under the conditions of stabilized plasma conditions of the creative.
They are unusable in sudden offensive functions. Cockcroft and Gault's estimation of Creainin clearance (Ckr) is considered obsolete in the professional community.
Currently, efforts are being made to introduce eGF using MDRD (Modification of Diet for Kidney Disease) formulas, which may lead to closer possible GF values. Based on current knowledge, a simplified MDRD equation with four variables is recommended for estimating glomerular filtration rate: eGF = 547.1535. -1.154. age-0.203 0.742 (women). 1.21 (black population) [ml.s-1.73 m-2].