IIDENTIFYING CLINICAL AND BIOCHEMICAL PREDICTORS OF PROGRESSION OF DIABETIC KIDNEY DISEASE

2000 WORDS

Despite the convenience of quick estimates, the eGFR does come with its limitations as a biomarker for the diagnosis of diabetic kidney disease. Serum creatinine levels can be influenced by muscle mass and diet, especially meat intake [12] which would therefore have an effect on the eGFR calculation.

Inaccuracies may also arise from the equation in certain circumstances. In patients with a GFR > 60 mL/min per 1.73 m2, the MDRD equation becomes less accurate [13]. As glomerular hyperfiltration is a sign of an early stage disease, this would cause a problem in the early diagnosis of diabetic kidney disease. Conversely, the CKD-EPI equation is more reliable for patients with a GFR > 90 mL/min per 1.73 m2 [14]. This would therefore be a more accurate equation to use with diabetic patients – why?

The P30 value of both equations is between 80% and 90% which means the eGFR calculations from the equations have a 80-90% chance of being within 30% of the GFR. (add some other stuff to transition to conclusion)

Therefore eGFR alone should not be used a sole marker for diagnosis of diabetic kidney disease.

Despite the convenience of quick estimates, the eGFR does come with its limitations as a biomarker for the diagnosis of diabetic kidney disease. Serum creatinine levels can be influenced by muscle mass and diet, especially meat intake [12] which would therefore have an effect on the eGFR calculation.

Inaccuracies may also arise from the equation in certain circumstances. In patients with a GFR > 60 mL/min per 1.73 m2, the MDRD equation becomes less accurate [13]. As glomerular hyperfiltration is a sign of an early stage disease, this would cause a problem in the early diagnosis of diabetic kidney disease. Conversely, the CKD-EPI equation is more reliable for patients with a GFR > 90 mL/min per 1.73 m2 [14]. This would therefore be a more accurate equation to use with diabetic patients – why?

The P30 value of both equations is between 80% and 90% which means the eGFR calculations from the equations have a 80-90% chance of being within 30% of the GFR. (add some other stuff to transition to conclusion)

Therefore eGFR alone should not be used a sole marker for diagnosis of diabetic kidney disease.