الفهرس 
Established and Emerging Markers of Kidney FunctionOnly 14 pages are availabe for public view
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Abstract
Chronic kidney disease (CKD) is frequently presented as a major public health issue, because a prevalence as high as 10% has been described in the general population of Western Countries .In addition, CKD is associated with a high mortality risk .In this context, prevention and screening of CKD could be of importance Creatinine is an imperfect marker of glomerular filtration because it is regularly secreted and at times reabsorbed by the renal tubules. Hence, creatinine clearance provides only a rough guide to the GFR. The complex nature of renal handling of creatinine is augmented by the fact that the degree of tubular secretion or reabsorption of creatinine is variable and unpredictable, especially in the presence of renal disease.
Tubular secretion of Creatinine is relatively small in normal GFR ranges but increases significantly as GFR declines to reach as much as 50% of Creatinine Clearance when GFR is <20-30ml/min. Therefore, eGFR is most likely to be useless in the evaluation of interventions aimed at impacting on the rate of GFR progression as when true GFR declines tubular secretion of creatinine increases confounding the use of serum creatinine as a parameter of progressive CKD. The aim of our study was to study the possible value of GFR measurement by creatinine based equations in relation to renal pathology (tubulointerstitial changes). Our study was conducted on 20 patients randomly selected from nephrology outpatient clinic and nephrology department in Ain Shams University Hospitals. In our study we used iohexol clearance as a gold standard test, our results showed that no significant correlations between GFR measured by Cockroft Gold ,GFR_MDRD, GFR_CKD_EPI and iohexol clearance as a gold standard measure especially in moderate to severe tubular affection. The creatinine based equations underestimate GFR due to increase tubular secretion when GFR decline. This means that these equations are not accurate in GFR estimation in correlation to gold standard iohexol. GFR_cockroft Gault has no significant difference than GFR_iohexol in patients with moderate to severe tubular affection. GFR_cockroft Gault was the least bias in comparison to MDRD and CKD_EPI.