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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]
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.
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]
Effective renal plasma flow (eRPF) is a measure used in renal physiology [1] to calculate renal plasma flow (RPF) and hence estimate renal function.. Because the extraction ratio of PAH is high, it has become commonplace to estimate the RPF by dividing the amount of PAH in the urine by the plasma PAH level, ignoring the level in renal venous blood.
In renal physiology, the filtration fraction is the ratio of the glomerular filtration rate (GFR) over the renal plasma flow (RPF). Filtration Fraction, FF = GFR/RPF, or =. The filtration fraction, therefore, represents the proportion of the fluid reaching the kidneys that passes into the renal tubules. It is normally about 20%.
A glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m 2 is considered normal without chronic kidney disease if there is no kidney damage present. Kidney damage is defined as signs of damage seen in blood, urine, or imaging studies which include lab albumin/creatinine ratio (ACR) ≥ 30. [ 62 ]
Risk: 1.5-fold increase in the serum creatinine, or glomerular filtration rate (GFR) decrease by 25 percent, or urine output <0.5 mL/kg per hour for six hours. Injury: Two-fold increase in the serum creatinine, or GFR decrease by 50 percent, or urine output <0.5 mL/kg per hour for 12 hours.
The estimated glomerular filtration rate (eGFR) is a measure of kidney function. [6] Adding a race adjustment to kidney algorithms results in higher eGFR values in people identified as black. [ 7 ] [ 8 ] [ 9 ] Reasons for this vary, but it is thought to partially stem from the notion that Black persons are more muscular. [ 8 ]