{"id":22247,"date":"2021-10-25T22:46:55","date_gmt":"2021-10-26T03:46:55","guid":{"rendered":"https:\/\/saluddigital.com\/?p=22247"},"modified":"2025-10-21T11:49:17","modified_gmt":"2025-10-21T17:49:17","slug":"measurement-and-estimation-of-gfr-for-use-in-clinical-practice-core-curriculum-2021","status":"publish","type":"post","link":"https:\/\/saluddigital.com\/en\/resumen-de-cursos\/measurement-and-estimation-of-gfr-for-use-in-clinical-practice-core-curriculum-2021\/","title":{"rendered":"Measurement and Estimation of GFR for Use in Clinical Practice: Core Curriculum 2021"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"22247\" class=\"elementor elementor-22247\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6f34e246 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-equal-height-no\" data-id=\"6f34e246\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-51e1960a\" data-id=\"51e1960a\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5139b4eb elementor-widget elementor-widget-text-editor\" data-id=\"5139b4eb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Key points<\/strong><\/p><ul><li>Glomerular filtration rate (GFR) refers to the ability of the glomeruli to filter plasma and form ultrafiltrate.<\/li><li>GFR is a tool used in the diagnosis, staging, and management of chronic kidney disease (CKD), as well as to calculate drug doses and establish a prognosis or predict mortality.<\/li><li>The normal range of GFR in healthy patients is from 100 to 125 mL\/min per 1.73 m<sup>2<\/sup>. While CKD is considered when we find a GFR level &lt; 60 mL\/min per 1.73 m<sup>2<\/sup>, or evidence of kidney damage (albuminuria) for more than 3 months.<\/li><li>Direct measurement methods are expensive, invasive and not available to everyone, so indirect methods or those estimated from the concentration of endogenous substances are recommended in clinical practice. <strong>Of these, the most used are creatinine and Cystatin C.<\/strong><\/li><li>Creatinine:<ul><li><u>Advantage<\/u>: low cost, easy to obtain and perform test, short time, minimally invasive.<\/li><li><u>Disadvantages<\/u>: tends to overestimate the GFR (the lower the level, the higher the overestimation). Factors that can alter your result: health status, body composition (muscle mass), diet, physical activity, medications.<\/li><\/ul><\/li><li>Cystatin C:<ul><li><u>Advantage<\/u>: higher accuracy than creatinine. Less influenced by external factors such as age, gender and race. Factors that can alter its result: inflammation, obesity, thyroid disorders.<\/li><li><u>Disadvantages<\/u>: Higher cost.<\/li><\/ul><\/li><li>The recommendation is that the most used equations to estimate GFR from creatinine are the <a href=\"https:\/\/www.senefro.org\/modules.php?name=calcfg\">CKD-PPE<\/a> (Chronic Kidney Disease Epidemiology Collaboration) in adults and the <a href=\"https:\/\/www.kidney.org\/professionals\/kdoqi\/gfr_calculatorped\">CKiD<\/a> (CKD in Children Schwartz \u201cbedside\u201d) in children.<ul><li>Cockcroft-Gault: underestimates GFR, is unreliable in older adults, patients with obesity, and edematous states.<\/li><li>MDRD formula: underestimates GFR, the higher the GFR, the more it underestimates it.<\/li><\/ul><\/li><li>When a confirmatory test is required, it is suggested to use a 24-hour urine collection to measure creatinine, urea, and albumin clearance.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-41e02b5 elementor-align-center elementor-widget elementor-widget-button\" data-id=\"41e02b5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-md\" href=\"https:\/\/www.ajkd.org\/article\/S0272-6386(21)00707-1\/pdf\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">See more<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-46b5a8e7 elementor-section-boxed elementor-section-height-default elementor-section-height-default wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-equal-height-no\" data-id=\"46b5a8e7\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-70d68044\" data-id=\"70d68044\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-101b9c0e elementor-widget elementor-widget-toggle\" data-id=\"101b9c0e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-2701\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-2701\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">FONT<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-2701\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-2701\"><p><a href=\"https:\/\/www.ajkd.org\/article\/S0272-6386(21)00707-1\/fulltext\">https:\/\/www.ajkd.org\/article\/S0272-6386(21)00707-1\/fulltext<\/a><\/p><p><a href=\"https:\/\/www.senefro.org\/modules.php?name=calcfg\">https:\/\/www.senefro.org\/modules.php?name=calcfg<\/a><\/p><p><a href=\"https:\/\/www.kidney.org\/professionals\/kdoqi\/gfr_calculatorped\">https:\/\/www.kidney.org\/professionals\/kdoqi\/gfr_calculatorped<\/a><\/p><p><em>This content is created by PAES PROVITA S DE RL<\/em><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Puntos Clave La tasa de filtrado glomerular (TFG) se refiere a la capacidad de los glom\u00e9rulos para filtrar el plasma y formar el ultrafiltrado. La TFG es una herramienta utilizada en el diagn\u00f3stico, estadio, manejo de la enfermedad renal cr\u00f3nica (ERC), as\u00ed como para calcular dosis de medicamentos y establecer un pron\u00f3stico o predecir mortalidad. El rango normal de TFG en pacientes sanos va de 100 a 125 mL\/min per 1.73 m2. Mientras que la ERC se considera cuando encontramos un nivel de TFG &lt; 60 mL\/min per 1.73 m2, o evidencia de da\u00f1o renal (albuminuria) por m\u00e1s de 3 meses. Los m\u00e9todos directos de medici\u00f3n son caros, invasivos y no est\u00e1n disponibles para todos, por lo que en la pr\u00e1ctica cl\u00ednica se recomiendan los m\u00e9todos indirectos o estimados a partir de la concentraci\u00f3n de sustancias end\u00f3genas. De \u00e9stas las m\u00e1s utilizadas son la creatinina y la Cistatina C. Creatinina: Ventajas: bajo costo, prueba f\u00e1cil de obtener y realizar, poco tiempo, poco invasiva. Desventajas: tiende a sobreestimar la TFG (a menor nivel, mayor sobreestimaci\u00f3n). Factores que pueden alterar su resultado: estado de salud, composici\u00f3n corporal (masa muscular), dieta, actividad f\u00edsica, medicamentos. Cistatina C: Ventajas: mayor precisi\u00f3n que la creatinina. Menos influenciado por factores externos como edad, g\u00e9nero y raza. Factores que pueden alterar su resultado: inflamaci\u00f3n, obesidad, alteraciones tiroideas. Desventajas: mayor costo. La recomendaci\u00f3n es que las ecuaciones m\u00e1s utilizadas para estimar la TFG a partir de la creatinina sean la CKD-EPI (Chronic Kidney Disease&nbsp;Epidemiology Collaboration) en adultos y la CKiD (CKD in Children Schwartz \u201cbedside\u201d) en ni\u00f1os. Cockcroft-Gault: subestima la TFG, es poco confiable en adultos mayores, pacientes con obesidad y estados edematosos. F\u00f3rmula MDRD: subestima la TFG, mientras mayor es la TFG m\u00e1s la subestima. Cuando se requiere un examen confirmatorio, se sugiere utilizar recolecci\u00f3n de orina de 24 horas para medici\u00f3n de depuraci\u00f3n de creatinina, urea y albumina. Ver m\u00e1s FUENTE https:\/\/www.ajkd.org\/article\/S0272-6386(21)00707-1\/fulltext https:\/\/www.senefro.org\/modules.php?name=calcfg https:\/\/www.kidney.org\/professionals\/kdoqi\/gfr_calculatorped Este contenido es creaci\u00f3n de PAES PROVITA S DE RL<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3398],"tags":[],"class_list":["post-22247","post","type-post","status-publish","format-standard","hentry","category-resumen-de-cursos"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/posts\/22247","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/comments?post=22247"}],"version-history":[{"count":0,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/posts\/22247\/revisions"}],"wp:attachment":[{"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/media?parent=22247"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/categories?post=22247"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/saluddigital.com\/en\/wp-json\/wp\/v2\/tags?post=22247"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}