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Endogenous markers for estimation of kidney function

Project assistant: Maria Ahlberg
Contact person: Ingegerd Mejàre
E-mail to contact person: mejare@sbu.se
Planned publish date: Winter 2012
Project group: 
Carl-Gustaf Elinder (Chair), Professor, Nephrology, Stockholm
Anders Alvestrand, Professor Emeritus, Nephrology, Stockholm
Charlotte Asker-Hagelberg, Associate Professor, Clinical Pharmacology, Stockholm
Max Bell, M.D., Anaesthesia and Intensive Care, Stockholm
Ulla Berg, Professor Emeritus, Paediatrics, Stockholm
Jonas Björk, Associate Professor, Statistics, Lund
Sten-Erik Bäck, M.D., Clinical Chemistry, Kristianstad
Anders Grubb, Professor, Clinical Chemistry, Lund
Anders Larsson, Professor, Clinical Chemistry, Uppsala
Patrik Midlöv, M.D., Family Medicine, Malmö
Ulf Nyman, Associate Professor, Radiology, Trelleborg
Per Sjöström, Associate Professor, Nephrology, Örebro
Inga Soveri, M.D., Internal Medicine, Uppsala
Gunnar Sterner, Associate Professor, Nephrology and Transplantation, Malmö
Maria Svensson, Associate Professor, Nephrology, Göteborg
From SBU:
Susanne Vilhelmsdotter Allander, Assistant Project Manager
Maria Ahlberg, Project Assistant
Lars-Åke Marké and Anders Norlund, Health Economists
 

Estimating kidney function – which marker is best?
Although many blood samples are taken for the purpose of measuring kidney function, the best test has not yet been determined. Creatinine is among the most common analyses used by Swedish laboratories, and the newer test of cystatin C is spreading rapidly. SBU is now assessing the methods scientifically. Approximately 10 million analyses of creatinine are performed in Sweden every year. Meanwhile, a growing number of tests are based on the newer, somewhat more expensive, cystatin C. The choice of test may have major economic repercussions. Which test best measures kidney function is not yet known – experts differ and clinical practice varies. Many different groups of patients and medical specialities are involved. The SBU project group is gathering and reviewing available research findings for creatinine and cystatin C as methods of measuring kidney function. The group will also assess reference methods to determine which ones are acceptable for comparison purposes.

Questions the project group will address
•  Which marker best measures kidney function: creatinine or cystatin C?
•  What mathematical formulas should be used to calculate kidney function based on creatinine and cystatin C?
•  What are the situations in which each marker is preferable?

Deciding which marker to use when estimating kidney function must consider a series of factors, including gender, age, weight, muscle mass, drug dosage, new diagnosis, monitoring of disease, whether a condition is acute or chronic, intensive care, pregnancy, suppressed immune system,transplantation, and when chosing the right dosage of drugs.

 

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