Estimated glomerular filtration rate in clinical practice: Consensus positioning of the Brazilian Society of Nephrology (SBN) and Brazilian Society of Clinical Pathology and Laboratory Medicine (SBPC/ML)
J Bras Nefrol. 2024 Apr 5;46(3):e20230193.
doi: 10.1590/2175-8239-JBN-2023-0193en.
eCollection 2024.
[Article in
English,
Portuguese]
Authors
Gianna Mastroianni Kirsztajn
1
2
, Geraldo Bezerra da Silva Junior
1
3
, Artur Quintiliano Bezerra da Silva
1
4
, Hugo Abensur
1
5
, João Egídio Romão Junior
1
5
, Marcus Gomes Bastos
1
6
7
, Viviane Calice-Silva
1
8
9
, Lilian Pires de Freitas do Carmo
1
10
, Tainá Veras de Sandes-Freitas
1
11
, Patrícia Ferreira Abreu
1
2
, Bruna Dolci Andreguetto
2
, Luiz Gustavo Ferreira Cortes
12
13
, Maria Gabriela de Lucca Oliveira
2
, Luisane Maria Falci Vieira
12
14
, José A Moura-Neto
1
15
, Adagmar Andriolo
2
12
Affiliations
- 1 Sociedade Brasileira de Nefrologia, São Paulo, SP, Brazil.
- 2 Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil.
- 3 Universidade de Fortaleza, Centro de Ciências da Saúde, Programas de Pós-Graduação em Ciências Médicas e Saúde Coletiva, Fortaleza, CE, Brazil.
- 4 Universidade Federal do Rio Grande do Norte, Departamento de Medicina Integrada, Natal, RN, Brazil.
- 5 Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil.
- 6 Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, MG, Brazil.
- 7 Faculdade Ubaense Ozanam Coelho, Ubá, MG, Brazil.
- 8 Universidade da Região de Joinville, Joinville, SC, Brazil.
- 9 Fundação Pró-Rim, Joinville, SC, Brazil.
- 10 Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil.
- 11 Universidade Federal do Ceará, Faculdade de Medicina, Fortaleza, CE, Brazil.
- 12 Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial, Rio de Janeiro, RJ, Brazil.
- 13 Hospital Israelita Albert Einstein, Laboratório Clínico, São Paulo, SP, Brazil.
- 14 Dasa - Diagnósticos da América S.A., São Paulo, SP, Brazil.
- 15 Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
Abstract
Chronic kidney disease (CKD) represents one of today's main public health problems. Serum creatinine measurement and estimation of the glomerular filtration rate (GFR) are the main tools for evaluating renal function. There are several equations to estimate GFR, and CKD-EPI equation (Chronic Kidney Disease - Epidemiology) is the most recommended one. There are still some controversies regarding serum creatinine measurement and GFR estimation, since several factors can interfere in this process. An important recent change was the removal of the correction for race from the equations for estimating GFR, which overestimated kidney function, and consequently delayed the implementation of treatments such as dialysis and kidney transplantation. In this consensus document from the Brazilian Societies of Nephrology and Clinical Pathology and Laboratory Medicine, the main concepts related to the assessment of renal function are reviewed, as well as possible existing controversies and recommendations for estimating GFR in clinical practice.
MeSH terms
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Brazil
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Consensus
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Creatinine
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Glomerular Filtration Rate
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Humans
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Nephrology*
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Pathology, Clinical*
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Renal Dialysis
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Renal Insufficiency, Chronic* / diagnosis
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Renal Insufficiency, Chronic* / therapy