Chronic kidney disease and automatic reporting of estimated glomerular filtration rate

New developments and revised recommendations

David Johnson, Graham Jones, Timothy Mathew, Marie Ludlow, Matthew Doogue, Matthew Jose, Robyn Langham, Paul Lawton, Steven McTaggart, Michael Peake, Kevan Polkinghorne, Tim Usherwood

    Research output: Contribution to journalEditorialResearchpeer-review

    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 90 mL/min/1.73 m2.

    ·         Age-related decision points for eGFR in adults are not recommended, as although an eGFR < 60 mL/min/1.73 m2 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.

     

    Original languageEnglish
    Pages (from-to)1-5
    Number of pages5
    JournalMedical Journal of Australia
    Volume197
    Issue number4
    DOIs
    Publication statusPublished - 2012

    Fingerprint

    Glomerular Filtration Rate
    Chronic Renal Insufficiency
    Creatinine
    Publications
    Epidemiology
    Kidney Function Tests
    Drug Monitoring
    Validation Studies
    Enzyme Assays
    Body Size
    Pharmaceutical Preparations
    Population
    Pregnant Women
    Pediatrics
    Serum

    Cite this

    Johnson, David ; Jones, Graham ; Mathew, Timothy ; Ludlow, Marie ; Doogue, Matthew ; Jose, Matthew ; Langham, Robyn ; Lawton, Paul ; McTaggart, Steven ; Peake, Michael ; Polkinghorne, Kevan ; Usherwood, Tim. / Chronic kidney disease and automatic reporting of estimated glomerular filtration rate : New developments and revised recommendations. In: Medical Journal of Australia. 2012 ; Vol. 197, No. 4. pp. 1-5.
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    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 90 mL/min/1.73 m2. ·         Age-related decision points for eGFR in adults are not recommended, as although an eGFR < 60 mL/min/1.73 m2 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.  ",
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    Johnson, D, Jones, G, Mathew, T, Ludlow, M, Doogue, M, Jose, M, Langham, R, Lawton, P, McTaggart, S, Peake, M, Polkinghorne, K & Usherwood, T 2012, 'Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: New developments and revised recommendations', Medical Journal of Australia, vol. 197, no. 4, pp. 1-5. https://doi.org/10.5694/mja11.11329

    Chronic kidney disease and automatic reporting of estimated glomerular filtration rate : New developments and revised recommendations. / Johnson, David; Jones, Graham; Mathew, Timothy; Ludlow, Marie; Doogue, Matthew; Jose, Matthew; Langham, Robyn; Lawton, Paul; McTaggart, Steven; Peake, Michael; Polkinghorne, Kevan; Usherwood, Tim.

    In: Medical Journal of Australia, Vol. 197, No. 4, 2012, p. 1-5.

    Research output: Contribution to journalEditorialResearchpeer-review

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    AU - Johnson, David

    AU - Jones, Graham

    AU - Mathew, Timothy

    AU - Ludlow, Marie

    AU - Doogue, Matthew

    AU - Jose, Matthew

    AU - Langham, Robyn

    AU - Lawton, Paul

    AU - McTaggart, Steven

    AU - Peake, Michael

    AU - Polkinghorne, Kevan

    AU - Usherwood, Tim

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