Dr. Glassock notes that "the introduction of the concept of eGFR by equations such as MDRD has had a dramatic increase on the awareness of CKD," but he also expresses concern that the equation "has resulted in an increase in false positive diagnoses of CKD, as well as the number of possibly unnecessary referrals to nephrologists." The interpretation of eGFR from serum creatinine values is a common occurrence in clinical practice, and physicians need to understand the potential pitfalls and inaccuracies as well as benefits in order to achieve optimum patient care.

Dr. Glassock recommends using the test to establish the severity of existing CKD but not for initial diagnosis or for qualifying living donors. In those instances, an analysis of freshly voided urine for cells, protein, and glucose should accompany a serum creatinine measurement for diagnosis of CKD, he says.

The podcast on eGFR follows the series entitled "Controversies in Nephrology" that appeared in the September 2008 issue of CJASN. ASN continues to lead the fight against kidney disease by highlighting complex areas of interest and controversy such as the appropriate use of eGFR measurements.

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