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After filtration, Cystatin C is reabsorbed and catabolized by the tubular epithelial cells, with only small amounts excreted in the urine. Cystatin C levels are therefore measured not in the urine, but in the bloodstream. Equations have been developed linking estimated GFR to serum cystatin C levels. [15]
The above formula only applies for GFR calculation when it is equal to the clearance rate. The normal range of GFR, adjusted for body surface area , is 100–130 average 125 (mL/min)/(1.73 m 2 ) in men and 90–120 (mL/min)/(1.73 m 2 ) in women younger than the age of 40.
If kidney function and glomerular filtration rate decline, the blood levels of cystatin C rise. Cross-sectional studies (based on a single point in time) suggest that serum levels of cystatin C are a more precise test of kidney function (as represented by the glomerular filtration rate, GFR) than serum creatinine levels.
This is the numerator in the equation. The denominator is the total amount of sodium filtered by the kidneys. This is calculated by multiplying the plasma sodium concentration by the glomerular filtration rate (GFR) calculated using creatinine filtration. The flow rates then cancel out, simplifying to the standard equation: [1]
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 ...
A better estimate of kidney function is given by calculating the estimated glomerular filtration rate (eGFR). eGFR can be calculated without a 24-hour urine collection, using serum creatinine concentration and some or all of the following variables: sex, age, and weight, as suggested by the American Diabetes Association. [19]
The GFR is derived from the serum creatinine and is proportional to 1/creatinine, i.e. it is a reciprocal relationship; the higher the creatinine, the lower the GFR. It reflects one aspect of kidney function, how efficiently the glomeruli – the filtering units – work. The normal GFR is >90 ml/min.
Typically, in an adult human, the net filtration pressure is 10mmHg and Kf 12.5mL/min/mmHg, giving a glomerular filtration rate (GFR) of 125mL/min. A decrease in Kf due to reduced number of glomeruli or reduced permeability will reduce the GFR at a given filtration pressure [ 3 ]
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