Blog entry by Meguid El Nahas

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by Meguid El Nahas - Saturday, 15 November 2014, 11:03 AM
Anyone in the world

eGFR has replaced true measured GFR in most nephrologists learned minds...

We are told in epidemiological studies that those with eGFR higher than 100 ml/min have a higher mortality....

We are told at ASN 2015 that those whose with CKD eGFR improves by >3ml/min/year have higher mortality...

We equate higher eGFR to "Hyperfiltration"... a concept that was debatable in rats...but fully accepted without a shred of evidence in humans...

We are told, and most believe, so many things in the name and at the altar of eGFR: estimated GFR....when in reality it is NEITHER ESTIMATED NOR MEASURED...it is simply calculated based on dubious, totally unecessary and misleading equations that PRETEND TO REFLECT TRUE AND MEASURED GFR...!!!

Therefore eGFR = iGFR: ILLUSION OF GFR...

As it is mostly:

Imprecise

Biased 

Inaccurate

in most general population studies:

http://www.ncbi.nlm.nih.gov/pubmed/23856996

and it is totaly unrepresentative of TRUE GFR in those who have advanced CKD4-5. Where tubular secretion of creatinine makes up to 40-50% of the urinary excretion of creatinine.

BUT MORE, SIGNIFICANTLY, eGFR IS THE MIRROR IMAGE OF SERUM CREATININE THAT FALLS WITH ILLNESS, ANOREXIA, MUSCLE WATING SARCOPENIA AND MALNUTRITION...SO:

of course those with high eGFR have higher mortality...they are wasted...

of course those with rising eGFR have worse prognosis and mortality...they are wasted....

of course those starting RRT/dialysis at higher eGFR are worse off...they are wasted... 

NOTHING TO DO WITH TRUE GFR JUST AN ILLUSION...OF GFR:

iGFR!  

[ Modified: Thursday, 1 January 1970, 1:00 AM ]

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