![]() However, we challenge this concept and the fact that the variable ‘age’ is poorly Following the ‘prognostic way’, the fixed cut-off of 60 mL/min/1.73 m2 has been retained in the K-DIGO guidelines. In adults older than 70 years, values below 60 mL/min/1.73 m2 could be considered normal. However, we know that GFR physiologically decreases with age, and GFR values are largely over 60 mL/min/1.73 m2 in healthy subjects, at least before the age of 70 years. Following the classical way, we can assert that normal Value at 60 mL/min/1.73 m2 according to the associated mortality risk (the ‘prognostic way’). In this context, we compare two perspectives:įirst the reference values defined by measuring GFR in normal individuals (the ‘classical way’) and secondly a fixed cut-off This article focuses on GFR and different ways to define its normal reference values. The seemingly lower estimated GFR in women may thus be the consequence of the well-known underestimation of true GFR by the MDRD formula in women.In nephrology, chronic kidney disease is defined by both proteinuria and measurement of glomerular filtration rate (GFR). Of note, our data do not necessarily reflect true GFR. As our healthy study participants had not used medication or contacted a physician in the 3 months before the study, the likelihood of major classification errors is small. ![]() Therefore, we may have overestimated the true prevalence of CKD stages 3–5 in our population. Correct classification of CKD stage 3–5 requires decreased GFR values for a period of at least three months. We have measured serum creatinine at one time point only. Limiting the analysis to this subgroup had no major effect: only for the age groups >80 years (with few remaining persons), the fifth percentile was higher at values of 45 ml/min/1.73 m 2. Fifty-three percent of the study participants denied any contact with such health-care professionals. Participants were also asked if they had seen their family physician or a hospital specialist within 3 or 12 months before the study, respectively. Thus, persons who are unaware of a underlying comorbidity may be incorrectly classified as ‘healthy’. We have used a questionnaire to ascertain the health status of the participants. Our study provides age- and gender-specific reference values of GFR in a population of Caucasian persons without identifiable risk. In these healthy persons, GFR declined approximately 0.4 ml/min/year. The median GFR was 85 ml/min/1.73 m 2 in 30–to 34-year-old men and 83 ml/min/1.73 m 2 in similar aged women. This healthy study cohort included 1660 male subjects and 2072 female subjects, of which 869 of both genders were 65 years or older. A reference population of apparently healthy subjects was selected by excluding persons with known hypertension, diabetes, cardiovascular- or renal diseases. ![]() The study cohort included 2823 male and 3274 female Caucasian persons aged 18–90 years. To limit possible bias, serum creatinine was calibrated against measurements performed in the original MDRD laboratory. The GFR was then measured using the abbreviated Modification of Diet in Renal Disease (MDRD) formula. In a large subset of the responders, serum creatinine was measured. Age-stratified, randomly selected inhabitants received a postal questionnaire on lifestyle and medical history. As part of the overall study, we provide reference values of estimated glomerular filtration rate (GFR) for this Caucasian population without expressed risk. The Nijmegen Biomedical Study is a population-based cross-sectional study conducted in the eastern part of the Netherlands.
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