Challenges in Measuring Glomerular Filtration Rate: A Clinical Laboratory Perspective

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

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

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)84-92
Number of pages9
JournalAdvances in Chronic Kidney Disease
Volume25
Issue number1
DOIs
StatePublished - Jan 2018

Bibliographical note

Funding Information:
Financial Disclosure: J.H.E. has performed consulting services for the Gentian Corporation. J.C.L. has a research project on Beta-trace protein with Siemens and past research grant for cystatin C work from Gentian Corporation.

Publisher Copyright:
© 2017 National Kidney Foundation, Inc.

Keywords

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

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