Serum Creatinine And Other Measures Of Gfr In Diabetes

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Peter Rossing

Steno Diabetes Center, Niels Steensens Vej 2, 2820 Gentofte, Denmark

The measurement of renal function or the glomerular filtration rate (GFR) in diabetes can be used

1) to estimate the renal clearance of drugs to guide dosing or to identify patients at increased risk for radiocontrast-induced acute renal failure,

2) for confirming the need for treatment of end stage renal disease, or

3) to measure progression of chronic renal disease i.e. diabetic nephropathy.

The evaluation of progression in renal disease is important in the clinical setting for the monitoring of development of renal insufficiency and evaluation of the effectiveness of treatment in the individual. In research it is important to evaluate the impact of putative promoters of progression in renal disease in observational studies or to assess and compare the rate of progression in experimental groups in clinical trials. In order to obtain a valid assessment of the rate of decline in GFR it is necessary with regular measurements of GFR over a period of at least (2)-3 years applying a method with high precision and accuracy [1]. This is due to the usually rather slow rate of decline in GFR in diabetic nephropathy. The ideal method for assessing GFR does not exist and the available methods differ regarding precision and accuracy, cost, inconvenience and safety. In general the more precise methods are being more expensive and inconvenient. Thus one has to select a method according to the clinical situation.

Mogensen CE (ed.) THE KIDNEY AND HYPERTENSION IN DIABETES MELLITUS. Copyright© 2004 by Martin Dunitz, a member of the Taylor & Francis Group, plc. All rights reserved.

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