Estimate kidney function using serum creatinine levels. Essential tool for medical professionals in nephrology.
Disclaimer: This tool is for educational purposes only. It does not replace professional medical advice. Clinical decisions should be based on comprehensive assessment by qualified healthcare providers.
The glomerular filtration rate (GFR) is the best overall index of kidney function. It represents the flow rate of filtered fluid through the kidneys. Estimated GFR (eGFR) is calculated from serum creatinine levels and other factors.
Key Concepts:
| Stage | eGFR (mL/min/1.73m²) | Description | Clinical Management |
|---|---|---|---|
| G1 | ≥ 90 | Normal or high | Monitor, treat underlying conditions |
| G2 | 60-89 | Mildly decreased | Monitor, reduce risk factors |
| G3a | 45-59 | Mild to moderate decrease | Evaluate and treat complications |
| G3b | 30-44 | Moderate to severe decrease | Evaluate and treat complications |
| G4 | 15-29 | Severely decreased | Prepare for renal replacement therapy |
| G5 | < 15 | Kidney failure | Renal replacement therapy |
CKD-EPI (2009) Formula: Most accurate formula for estimating GFR, recommended by KDIGO guidelines. More accurate at higher GFR levels than MDRD.
MDRD (Modification of Diet in Renal Disease) Formula: Widely used 4-variable formula. Less accurate at higher GFR levels (>60 mL/min/1.73m²).
Cockcroft-Gault Formula: Estimates creatinine clearance rather than GFR. Requires weight. Older formula still used for drug dosing.
Schwartz Formula (Pediatric): Used for children and adolescents. GFR = k × height(cm) / serum creatinine(mg/dL).
Muscle Mass: Creatinine production depends on muscle mass. Low muscle mass may overestimate GFR.
Dietary Protein: High meat intake can temporarily increase serum creatinine.
Medications: Some drugs affect creatinine production or secretion (e.g., trimethoprim, cimetidine).
Pregnancy: GFR normally increases during pregnancy by 40-50%.
Acute Illness: eGFR formulas are validated for stable outpatients, not acute illness.
Clinical Note: eGFR is an estimate and should be interpreted in the context of the patient's clinical condition. Confirmatory tests (24-hour urine collection for creatinine clearance, cystatin C) may be needed in specific situations. Always follow clinical guidelines for diagnosis and management of kidney disease.