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For Debate

eGFR — use beyond the evidence

Jennifer H Martin, Michael F Fay and Jacobus P Ungerer
MJA 2009; 190 (4): 197-199
Abstract
  • The estimated glomerular filtration rate (eGFR) algorithm has some advantages over serum creatinine concentration for estimating GFR.

  • There are a number of caveats around the use of eGFR, predominantly because it assumes subjects are of average body size and similar lean body weight.

  • eGFR has not been validated as a safe method of adjusting drug dosing, nor as a screening test for impaired renal function in the general population.

  • eGFR has not been validated as a robust measure of kidney function in many groups (eg, older people, inpatients, differing racial groups, obese people).

  • eGFR is inaccurate in many settings, such as in high, low or rapidly changing GFRs.

  • Until evidence of safety and efficacy is provided, eGFR should not be used for calculating drug doses, and use of the Cockcroft–Gault formula or other validated methods should continue.

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©The Medical Journal of Australia 2009 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377