Renal Function Tests

In medicine (nephrology) renal function is an indication of the state of the kidney and its role in physiology. Most doctors use creatinine, urea and electrolytes to determine renal function. These measures are adequate to determine whether a patient is suffering from kidney disease.

Unfortunately, BUN and creatinine will not be outside the normal range until 60% of total kidney function is lost. Hence, creatinine clearance is a more accurate measure and is used whenever renal disease is suspected or careful dosing of nephrotoxic drugs is required.

Glomerular filtration rate: In renal patients, the glomerular filtration rate (GFR) is used. This is calculated by comparing urine creatinine levels with the blood test results. It gives a more precise indication of the state of the kidneys. The GFR is expressed in ml/min. For most patients, a GFR over 60 ml/min is adequate.

Cockroft-Gault formula: A commonly used surrogate marker for actual creatinine clearance is the Cockroft-Gault formula, which employs creatinine measurements and a patient's weight to predict the clearance.

MDRD formula: The most recently advocated formula for calculating the GFR is the one that was developed as a result of the Modification of Diet in Renal Disease (MDRD) study.

Children: Schwartz: In children, the Schwartz formula is used. This employs the serum creatinine, the child's height and a constant to estimate the creatinine clearance.