Challenges in estimating GFR in Asia

  • 1 Vivek Kumar, MD, is assistant professor in the Department of Nephrology, PGIMER, Chandigarh, India. Vivekanand Jha, MD, is executive director, The George Institute for Global Health, India, professor of nephrology and James Martin Fellow, University of Oxford Conjoint Professor of Medicine, University of New South Wales, Sydney. He is president-elect of the International Society of Nephrology.
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Asia, home to 60% of the world’s population, is a unique showcase of geographic, racial, and ethnic diversity that has potential implications for disease diagnosis and management. Use of serum creatinine–based estimated GFR (eGFR) equations for diagnosis and staging of chronic kidney disease (CKD) is a perfect example that exemplifies these challenges.

Kidney Disease Improving Global Outcomes (KDIGO) currently recommends Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation (CKD-EPICr) for diagnosis and staging of CKD, but encourages use of a validated equation in the local population, if available.

Dietary protein intake and muscle mass, key determinants of steady state serum