The Intern At Work: Internal Medicine 272. (Repeat) The Internist's Guide To CKD
Feb 23, 2025
Dr. Lisa Dubrofsky, a nephrologist from Toronto with expertise in hypertension and cardiology, shares vital insights on chronic kidney disease (CKD) management. She discusses pivotal changes in CKD guidelines, including the significance of albuminuria and standardized equations for kidney function assessment. Dr. Dubrofsky also explores the potential of cystatin C as a diagnostic marker and highlights innovative treatments, such as SGLT2 inhibitors and finirinone, reshaping nephrology. Get ready for an engaging dive into the future of kidney care!
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Preferred GFR Equation
- Use the CKD-EPI creatinine equation for estimating GFR as it is more accurate across a wide GFR range.
- Avoid older equations like Cockcroft-Gault when possible due to assay standardization issues.
Cystatin C's Limited Use
- Cystatin C is an alternative kidney filtration marker released by all nucleated cells.
- In Canada, it is rarely used due to cost, limited impact on management, and availability.
Urine Testing for CKD
- Use urine albumin-to-creatinine ratio for CKD diagnosis and monitoring rather than protein-to-creatinine ratio.
- In non-albumin protein diseases like multiple myeloma, use protein-to-creatinine ratio or electrophoresis tests.