How can GFR estimates be used to detect progression?
The reciprocal relationship between GFR and serum creatinine levels makes it difficult for clinicians to appreciate the level and rate of change in GFR by monitoring serum creatinine. For example, for a 50-year-old white male, a change in serum creatinine from 1.0 to 2.0 mg/dl (88.4 to 176.8 µmol/L) reflects a decline in GFR of 46 mL/min/1.73 m2 (from 84 to 38 mL/min/1.73 m2), whereas a further increase in serum creatinine level from 2.0 to 3.0 mg/dL (176.8 to 265.2 µmol/L) reflects a further decline of only 14 mL/min/1.73 m2 (to 24 mL/min/1.73 m2). Current guidelines recommend using GFR estimates to monitor progression of CKD.
