TY - CHAP M1 - Book, Section TI - Evaluation of Kidney Function A1 - Dowling, Thomas C. A2 - DiPiro, Joseph T. A2 - Talbert, Robert L. A2 - Yee, Gary C. A2 - Matzke, Gary R. A2 - Wells, Barbara G. A2 - Posey, L. Michael PY - 2017 T2 - Pharmacotherapy: A Pathophysiologic Approach, 10e AB - KEY CONCEPTS The stage of chronic kidney disease (CKD) should be determined for all individuals based on the level of kidney function, independent of etiology, in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) classification system. Persistent proteinuria indicates the presence of CKD and is associated with mortality and risk of end-stage renal disease (ESRD). Quantitation of urine protein excretion, such as the measurement of a spot urine albumin-to-creatinine ratio, is critical for determining the severity of CKD and monitoring the rate of disease progression. The glomerular filtration rate (GFR) is the single best indicator of kidney function. Measurement of the GFR is most accurate when performed following the exogenous administration of iohexol, iothalamate, or radioisotopes such as technetium-99m diethylenetriamine pentaacetic acid (99mTc-DTPA). Equations to estimate creatinine clearance (CLcr) or GFR are commonly used in ambulatory and inpatient settings, and incorporate patient laboratory and demographic variables such as serum creatinine concentration (Scr), cystatin C, age, sex, weight, and ethnicity. Longitudinal assessment of GFR and albuminuria is important for monitoring the efficacy of therapeutic interventions, such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, which are used to slow or halt the progression of kidney disease. Assessments of kidney structure and function, such as radiography, computed tomography, magnetic resonance imaging, sonography, and biopsy, are predominantly used for determining the diagnosis of a given condition. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1145184572 ER -