Tagged: Nephrologists

In reply to “Estimating GFR: The Devil Is in the Details”

We thank Delanaye and Pottel for their response letter, which raises some important points. Our main goal was to assess the relative accuracies of eGFR equations based on creatinine, cystatin C, BTP, and B2M in hospitalized older adults. We found that the addition of cystatin C to creatinine-based equations improved accuracy, whereas the addition of BTP and/or B2M did not. This corroborates earlier literature, but it is one of only a few such studies among elderly multimorbid patients. These patients are at a disproportionately high risk of inaccurate GFR estimates and adverse outcomes related to such errors1, but they are...

Patient-Centered Quality Measures for Dialysis Care: A Report of a Kidney Disease Outcomes Quality Initiative (KDOQI) Scientific Workshop Sponsored by the National Kidney Foundation

Providing high quality patient-centered care is the central mission of dialysis facilities. Assessing quality and patient-centeredness of dialysis care is necessary for continuous dialysis facility improvement. Based predominantly on readily measured items, current quality measures in dialysis care emphasize biochemical and utilization outcomes, with very few patient-reported items. Additionally, current metrics often do not account for patient preferences and may compromise patient-centered care by limiting the ability of providers to individualize quantifiable care targets, such as dialysis adequacy based on patient priorities rather than a fixed numerical target.

Secular Trend in GFR Decline in Non-Dialysis CKD Based on Observational Data From Standard of Care Arms Of Trials

The standard of care (SoC) group of randomized controlled trials (RCTs) is a useful setting to explore the secular trends in kidney disease progression because implementation of best clinical practices is pursued for all patients enrolled in trials. The primary aim of this meta-analysis was to evaluate the secular trend in the change of GFR decline in the SoC arm of RCTs in CKD published in the last 30 years.

Estimating GFR: The Devil Is in the Details

We agree with the first conclusion of Iversen et al1 regarding the added value of cystatin C to estimate glomerular filtration rate (GFR) when used in combination with serum creatinine (sCr). This result is a confirmation of previous observations from much larger cohorts.2,3 It is a pity that this analysis has not taken into consideration the new European Kidney Function Consortium (EKFC) cystatin-based equation (and the combined equation).2 Also, the reference method used for GFR measurement is not ideal.