Skip to main content

Assessing Glomerular Filtration Rate in Older Adults

  • Chapter
  • First Online:
Managing Renal Injury in the Elderly Patient

Abstract

Accurate assessment of glomerular filtration rate (GFR) is important as it has multiple clinical implications. However in older adults and in patients with non-stable renal function (as it occurs during acute kidney injury for example) this is difficult. Most currently used GFR estimating equations based on serum creatinine were not developed and validated in populations of older adults. Besides, serum creatinine is known to be an imprecise endogenous filtration marker as it is strongly influenced by muscle mass. Two new serum creatinine- and serum Cystatin C-based eGFR equations have been specifically developed for older adults, however more confirmation of these findings by external validation is needed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kidney Disease: Improving Global Outcomes (KDIGO). Acute Kidney Injury Work Group (2012) KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl 2:1–138

    Google Scholar 

  2. Shlipak MG, Katz R, Sarnak MJ et al (2006) Cystatin C and prognosis for cardiovascular and kidney outcomes in elderly persons without chronic kidney disease. Ann Intern Med 145:237–246

    Article  PubMed  CAS  Google Scholar 

  3. National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39:S1–S266

    Google Scholar 

  4. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470

    Article  PubMed  CAS  Google Scholar 

  5. Stevens LA, Coresh J, Feldman HI et al (2007) Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol 18:2749–2757

    Article  PubMed  Google Scholar 

  6. Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41

    Article  PubMed  CAS  Google Scholar 

  7. Levey AS, Stevens LA, Schmid CH et al (2009) CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612

    Article  PubMed  Google Scholar 

  8. Inker LA, Schmid CH, Tighiouart H et al (2012) CKD-EPI Investigators. Estimating glomerular filtration rate from serum creatinine and cystatin C. N Engl J Med 367:20–29

    Article  PubMed  CAS  Google Scholar 

  9. Schaeffner ES, Ebert N, Delanaye P et al (2012) Two novel equations to estimate kidney function in persons aged 70 years or older. Ann Intern Med 157:471–481

    Article  PubMed  Google Scholar 

  10. Jelliffe R (1973) Creatinine clearance: Bedside estimate. Ann Intern Med 79:604

    Article  PubMed  CAS  Google Scholar 

  11. Jelliffe R (2002) Estimation of creatinine clearance in patients with unstable renal function, without a urine specimen. Am J Nephrol 22:320–324

    Article  PubMed  Google Scholar 

  12. Koppe L, Klich A, Dubourg L et al (2013) Performance of creatinine-based equations compared in older patients. J Nephrol 26:716–723

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elke Schaeffner MD, MSc (Epi), PD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Schaeffner, E. (2014). Assessing Glomerular Filtration Rate in Older Adults. In: Haase, M., Haase-Fielitz, A. (eds) Managing Renal Injury in the Elderly Patient. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39947-3_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-39947-3_3

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-39946-6

  • Online ISBN: 978-3-642-39947-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics