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The CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula was first published in May 2009. It was developed in an effort to create a formula more accurate than the MDRD formula, especially when actual GFR is greater than 60 mL/min per 1.73 m 2. This is the formula currently recommended by NICE in the UK. [27]
Levey is known for developing the most widely used equations to estimate GFR (renal function) globally.He pioneered work with the MDRD Study Equation, [1] led the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), which pooled measured kidney function CKD data from studies all over the world to develop equations to estimate kidney function from serum creatinine, cystatin C, and ...
The severity of chronic kidney disease (CKD) is described by six stages; the most severe three are defined by the MDRD-eGFR value, and first three also depend on whether there is other evidence of kidney disease (e.g., proteinuria): 0) Normal kidney function – GFR above 90 (mL/min)/(1.73 m 2) and no proteinuria
All people with a GFR <60 mL/min/1.73 m 2 for 3 months are defined as having chronic kidney disease. [59] Protein in the urine is regarded as an independent marker for worsening of kidney function and cardiovascular disease. Hence, British guidelines append the letter "P" to the stage of chronic kidney disease if protein loss is significant. [60]
Diagnosis of acute failure is often based on a combination of factors such as decreased urine production or increased serum creatinine. [3] Diagnosis of chronic failure is based on a glomerular filtration rate (GFR) of less than 15 or the need for renal replacement therapy. [1] It is also equivalent to stage 5 chronic kidney disease. [1]
Algorithms to estimate GFR from creatinine concentration and other parameters are discussed in the renal function article. Unfortunately, the MDRD Study equation was developed in people with chronic kidney disease, and its major limitations are imprecision and systematic underestimation of measured GFR (bias) at higher/normal values. [20]
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