From the Guidelines
Patientens nyrefunktion anses som normal. Med en estimeret glomerulær filtrationshastighed (eGFR) på 90 mL/min/1.73 m² og et kreatininniveau på 60 μmol/L, ligger patientens nyrefunktion inden for det normale område for en 28-årig kvinde, ifølge national kidney foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification 1. eGFR over 90 mL/min/1.73 m² indikerer en god filtrationshastighed i nyrerne. Kreatininniveauet på 60 μmol/L er også inden for normalområdet for en voksen kvinde (typisk 45-90 μmol/L) 1. Patientens nyrefunktion er normal, da en GFR på 90 mL/min/1.73 m² er over det niveau, der definerer kronisk nyresvigt (GFR < 60 mL/min/1.73 m²) 1. Ingen specifikke handlinger er nødvendige for nyrefunktionen, men patienten bør muligvis vurderes for årsager til andre mulige sundhedsproblemer, hvis nødvendigt. Det er vigtigt at bemærke, at serumkreatininniveauet kan påvirkes af andre faktorer end nyrefunktionen, såsom muskelmasse og køn 1. I dette tilfælde er patientens nyrefunktion normal, og der er ingen tegn på kronisk nyresvigt eller andre nyresygdomme.
From the Research
Renal Function Assessment
The assessment of renal function is crucial in determining the overall health of an individual, particularly in relation to kidney function.
- The estimated Glomerular Filtration Rate (eGFR) and serum creatinine levels are commonly used to estimate renal function 2, 3, 4.
- However, these markers have limitations, and their accuracy can be influenced by various factors such as age, muscle mass, and non-GFR determinants 2, 3.
eGFR and Serum Creatinine Levels
- An eGFR of 90 and a serum creatinine level of 60 may not necessarily indicate impaired renal function, as these values can be influenced by various factors 3, 4.
- The study by 3 highlights the importance of monitoring renal function in patients with cancer, as renal impairment can occur despite normal serum creatinine levels.
- Another study by 4 notes that creatinine has an imperfect but predictable association with the glomerular filtration rate (GFR), and other markers such as cystatin C may be used to estimate GFR.
Clinical Considerations
- The diagnosis and management of chronic kidney disease (CKD) require a systematic approach, taking into account various factors such as age, comorbidities, and renal function 4, 5.
- The use of angiotensin-converting enzyme (ACE) inhibitors in patients with heart failure and renal insufficiency can lead to an early rise in serum creatinine levels, but this does not necessarily indicate worsening renal function 5.
- A study by 6 found that patients with elevated serum creatinine and concurrent normal urinalysis may have underlying kidney disease, highlighting the importance of renal histology in diagnosis.
Renal Histology
- Renal histology can provide valuable information in diagnosing kidney disease, particularly in patients with elevated serum creatinine and normal urinalysis 6.
- The study by 6 found that patients with elevated serum creatinine and normal urinalysis may have various underlying kidney diseases, including acute interstitial nephritis and hypertensive nephrosclerosis.