Using eGFR to Detect CKD Not Cost Effective

WASHINGTON—Measuring glomerular filtration rates from routine blood work may not be not a cost-effective way to identify people with chronic kidney disease, according to a study in the February issue of the Clinical Journal of the American Society Nephrology.

The findings indicate that the potential benefit that this commonly used procedure provides for identifying individuals with previously unrecognized CKD can be easily reversed by the consequences of false positive diagnoses of CKD.

CKD affects more than 10 percent of Americans, many of whom are unaware of their disease. Because CKD increases an individual’s risk of developing cardiovascular disease, end-stage renal disease, and other serious health conditions, physicians are looking for effective ways to detect CKD so that treatment can be administered at early stages.

One method, estimating glomerular filtration rates (eGFR) though routine blood work, is being used by many clinics. This test indicates the volume of blood filtered by the kidneys over time, and its formula factors in measures of serum creatinine, age, gender, height, and weight. (Failing kidneys have a diminished ability to filter the molecule creatinine; therefore serum creatinine rises.)  Despite the popularity of this test, its use has not been fully analyzed.

To investigate, Harold Feldman, MD, of the University of Pennsylvania School of Medicine in Philadelphia, PA, and his colleagues compared reporting of eGFR with reporting of serum creatinine alone, another commonly used measure of kidney function.