ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Screening Tests In Kidney Diseases
Dr. Hadim AKOĞLU,a Dr. Bülent ALTUNa
aNefroloji BD, Hacettepe Üniversitesi Tıp Fakültesi, ANKARA
Screening for renal diseases is extremely important for early detection and intervention. Initial tests for the assesment of renal damage should be estimation of the glomerular filtration rate (GFR) and examination of the urinary sediment. Inulin clearance is regarded as the gold standart for measuring GFR. Estimating inulin clearance requires an intravenous infusion and timed urine collection making it costly and cumbersome. The most common methods utilized to estimate the GFR are based on the serum creatinine concentration and 24-hour creatinine clearance. Since the serum creatinine concentration is affected by various factors, it will be unreliable to provide an estimate of GFR based simply on serum creatinine concentration. Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equations specifically relie upon serum creatinine concentration measurements. These formulas also take into account the age, gender, and race. Thus, equations estimating GFR based on serum creatinin are more accurate and precise than estimates of GFR from measurement of serum creatinine alone. Because measuring 24-hour creatinine clearance to assess GFR is shown to be less reliable than estimating GFR from a prediction aquation, the equations based on serum creatinine concentration are proposed to assess GFR. Examination of the urinary sediment in conjunction with assessment of proteinuria, is useful in the detection of chronic kidney disease and in the identification of the type of kidney disease. There are quantitative and semi-quantitative tests available for the measurement of urinary protein. Generally, screening of and monitoring proteinuria should be performed using semi-quantitative and quantitative tests respectively. Appropriate use of the screening tests provide detection of high risk patients for kidney diseases and considering preventive measures and therapeutic interventions without a delay.Keywords: Kidney diseases, early diagnosis, kidney function tests, glomerular filtration rateTurkiye Klinikleri J Int Med Sci 2007, 3(38):8-18
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