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Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: New developments and revised recommendations

Citation

Johnson, DW and Jones, GRD and Mathew, TH and Ludlow, MJ and Doogue, MP and Jose, Matthew D and Langham, RG and Lawton, PD and McTaggart, SJ and Peake, MJ and Polkinghorne, K and Usherwood, T, Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: New developments and revised recommendations, Medical Journal of Australia, 197, (4) pp. 1-5. ISSN 0025-729X (2012) [Refereed Article]


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Copyright Statement

Copyright 2013 Medical Journal of Australia

DOI: doi:10.5694/mja11.11329

Abstract

  • The publication of the Australasian Creatinine Consensus Working Group's position statements in 2005 and 2007 resulted in automatic reporting of estimated glomerular filtration rate (eGFR) with requests for serum creatinine concentration in adults, facilitated the unification of units of measurement for creatinine and eGFR, and promoted the standardisation of assays. New advancements and continuing debate led the Australasian Creatinine Consensus Working Group to reconvene in 2010.
  • The working group recommends that the method of calculating eGFR should be changed to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, and that all laboratories should report eGFR values as a precise figure to at least 90mL/min/1.73m2.
  • Age-related decision points for eGFR in adults are not recommended, as although an eGFR<60mL/min/1.73m2 is very common in older people, it is nevertheless predictive of significantly increased risks of adverse clinical outcomes, and should not be considered a normal part of ageing.
  • If using eGFR for drug dosing, body size should be considered, in addition to referring to the approved product information. For drugs with a narrow therapeutic index, therapeutic drug monitoring or a valid marker of drug effect should be used to individualise dosing.
  • The CKD-EPI formula has been validated as a tool to estimate GFR in some populations of non-European ancestry living in Western countries. Pending publication of validation studies, the working group also recommends that Australasian laboratories continue to automatically report eGFR in Aboriginal and Torres Strait Islander peoples.
  • The working group concluded that routine calculation of eGFR is not recommended in children and youth, or in pregnant women. Serum creatinine concentration (preferably using an enzymatic assay for paediatric patients) should remain as the standard test for kidney function in these populations.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Nephrology and Urology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Urogenital System and Disorders
Author:Jose, Matthew D (Professor Matthew Jose)
ID Code:85005
Year Published:2012
Web of Science® Times Cited:14
Deposited By:Research Division
Deposited On:2013-06-11
Last Modified:2017-12-08
Downloads:0

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