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1 [1,2] (USRDS) 2005 ( ) 2001 (National Kidney Foundation, NKF) K-DOQI (1) (glomerular filtration rate, GFR) 3 (2) 60 ml/min/1.73m 2 3 [3-5] ( 1) 113 (serum creatinine) (Ketoacidosis) (degradation) trimethoprim cimetidine (creatinine clearance, CCr) [6,7] cystatin C Cystatin C 13 cystatin C cystatin C cystatin C cystatin C CRP cystatin C cystatin C ( )

2 1. Cockcroft-Gault (140-Age) Weight Ccr(ml/min) 72 Scr ( 0.85 if female) Ccr Scr mg/dl Age year Weight kg 2. Abbreviated MDRD Study Estimated GFR (ml/min/1.73m2) = 186 (Scr) (Age) ( if female) ( if black) = 175 (Standarized Scr) (Age) ( if female) ( if black) 2005( ) 7 3. Schwartz 4. Counahan-Barratt GFR= 0.55 Height (cm) Scr (mg dl) 5. GFR= Height (cm) Scr (mg dl) 1. cystatin C [8-12] (inulin) ( 99m Tc-DTPA 51 Cr-EDTA iohexol 125 I-iothalamate ) ( 1)

3 1. K-DOQI GFR(mL/min/1.73m 2 ) Cockcroft-Gault MDRD(Modification of Diet in Renal Disease) study ( 1) Cockcroft-Gault ml/min [7,13,14] Cockcroft-Gault 140 ( ) ( ) Cockcroft-Gault Cockcroft-Gault Cockcroft-Gault Cockcroft-Gault MDRD Study ( ) [7,15,16] MDRD Study Cockcroft-Gault ( ) [17-19] MDRD Study GFR 90 ml/min/1.73m 2 Cockcroft-Gault [20-22] MDRD Study [23] (www.kdoqi.org) MDRD Study abbreviated MDRD Study MDRD Study Schwartz Counahan-Barratt ( 1) Schwartz Counahan-Barratt

4 Schwartz % % % % % 7.4% 1 2.2% 2 2.8% 3 1.5% 4 0.9% 14.2% 91 (26.2%) % % % % % 14% 8.5% ( ) 0.3% ( ) 0.3% ( ) 7.9% ( ) 5.2% ( ) 1.2% 8.5% 24% % 71.4% 25% 8% 1.6 [24] ( ) ( ) 24 [7,23] ( 38.7%) ( 30.3%) ( 6.2%) ( 1.8%) ( 1.1%)

5 (65 ) ( ) ( ) [25] 1. Coresh J, Astor BC, Greene T, et al: Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003; 41(1): United States Renal Data System. Excerpts from the 2000 US Renal Data System Annual Data Report: Atlas of end stage renal disease in the United States. Am J Kidney Dis 2000; 36: S1-S National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification and stratification. Am J Kidney Dis 2002; 39 (Suppl 1): S1-S Levy AS, Coresh J, Bakl E, et al: National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003; 139: Levey AS, Eckardt KU, Tsukamoto Y, et al: Definition and classification of chronic kidney disease: a position statement from kidney disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67: Perrone RD, Madias NE, Levey AS: Serum creatinine as an index of renal function: New insights into old concepts. Clin Chem 1992; 38(10): Stevens LA, Coresh J, Greene T, et al: Assessing kidney function-measured and estimated glomerular filtration rate. New Engl J Med 2006; 345: Dharnidharka VR, Kwon C, Stevens G: Serum cystatin C is superior to serum creatinine as a marker kidney function: a meta-analysis. Am J Kidney Dis 2002; 40: Grubb AO: Cystatin C properties and use as diagnostic marker. Adv Clin Chem 2000: 35: Sjostrom P, Tidman M, Jones I: Determination of the production rate and non-renal clearance of cystatin C and estimation of the glomerular filtration rate from the serum concentration of cystatin C in humans. Scand J Clin Lab Invest 2005; 65: Keevil BG, Kilpartrick ES, Nichols SP, et al: biological variation of cystatin C: implications for the assessment of glomerular filtration rate. Clin Chem 1998; 44: Knight EL, Verhave JC, Spiegelman D, et al: Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Kidney Int 2004; 65: Cockcroft DW, Gault MH: Prediction of creatinine clearance from serum creatinine. Nephron 1976; 16: Sokoll LJ, Russell RM, Sadowski JA, et al: Establishment of creatinine clearance reference values for older women. Clin Chem 1994; 40: Levey AS, Bosch JP, Lewis JB, et al: for the Modification of Diet in Renal Disease Study Group. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Ann Intern Med 1999; 130(6): Myers GL, Miller WG, Coresh J, et al: Recommendations for improving serum creatinine measurement: a report from the Laboratory Working Group of the Nation Kidney Disease Education Program. Clin Chem 2006; 52: Froissart M, Rossert J, Jacquot C, et al: Predictive performance of the Modification of Diet in Renal Disease and Cockcroft-Gault equations for estimating renal function. J Am Sco Nephrol 2005; 16: Verhave JC, Fesler P, Ribstein J, et al: Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index. Am J Kidney Dis 2005; 46: Cirillo M, Anastasio P, De Santo JG: Relationship of gender, age, and body mass index to errors in predicted kidney function. Nephrol Dial Transplant 2005; 20: Poggio ED, Wang X, Greene T, et al: Performance of the Modification of Diet in Renal Disease and Cockcroft-Gault equations in the estimation of GFR in health and in chronic kidney disease. J Am Soc Nephrol 2005; 16: Rule AD, Larson TS, Bergstralh EJ, et al: Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney diseae. Ann Intern Med 2004; 141: Zuo L, Ma YC, Zhou YH, et al: Application of GFR-estimating equations in Chinese patients with chronic kidney disease. Am J Kidney Dis 2005; 45: Rosner MH, Bolton WK: Core curriculum in nephrology. Renal function testing. Am J Kidney Dis 2006; 47: Hsu CC, Hwang SJ, Wen CP, et al: High prevalence and low awareness of CKD in Taiwan: A study on the relationship between serum creatinine and awareness from a nationally representative survey. Am J Kidney Dis 2006; 48: Levey AS, Stevens LA, Hostetter T. Automatic reporting of estimated glomerular filtration rate just what the doctor ordered. Clin Chem 2006; 52:

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