Herget-Rosenthal et al recommended which way to estimate the glomerular filtration rate (GFR) for a patient. The authors are from the University of Duisburg-Essen, Vrije Universeit Medical Center (Amsterdam), and Stadtisches Klinikum Munchen.


Parameters to consider:

(1) approximate GFR in mL per min per 1.73 square meters BSA

(2) age of the patient

(3) body mass index (BMI)

(4) presence of the nephrotic syndrome

(5) presence of acute kidney injury


Indications for using serum cystatin C:

(1) estimated GFR 60 to 90 mL per min per 1.73 square meters BSA

(2) BMI > 30 kg per square meter

(3) nephrotic syndrome

(4) acute kidney injury


If the estimated GFR is < 20 mL per kg per 1.73 square meters BSA then use the average of the creatinine and urea clearances.


If none of the above apply, then use serum creatinine in one of the following equations:

(1) for an adult: Cockcroft-Gault or MDRD equation

(2) for a pediatric patient: Schwartz equation


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