When the nurse is assessing the glomerular filtration rate (GFR) of a patient, which method is more accurate when the patient's GFR is normal or mildly decreased?
A) Cockcroft-Gault equation
B) Modification of Diet in Renal Disease
C) Chronic Kidney Disease-Epidemiology Collaboration
D) RIFLE
C) Chronic Kidney Disease-Epidemiology Collaboration
Explanation: A) Cockcroft-Gault equation, which preceded the Modification of Diet in Renal Disease (MDRD) equation, may overestimate creatinine clearance. The MDRD equation is the equation that many laboratories still utilize when reporting GFR as part of the basic metabolic panel, but in 2009, the National Kidney Foundation recommended the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation to estimate the GFR. The CKD-EPI is preferred for better prediction of CKD risk and is more accurate when the GFR is normal or only mildly decreased.
B) Cockcroft-Gault equation, which preceded the Modification of Diet in Renal Disease (MDRD) equation, may overestimate creatinine clearance. The MDRD equation is the equation that many laboratories still utilize when reporting GFR as part of the basic metabolic panel, but in 2009, the National Kidney Foundation recommended the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation to estimate the GFR. The CKD-EPI is preferred for better prediction of CKD risk and is more accurate when the GFR is normal or only mildly decreased.
C) Cockcroft-Gault equation, which preceded the Modification of Diet in Renal Disease (MDRD) equation, may overestimate creatinine clearance. The MDRD equation is the equation that many laboratories still utilize when reporting GFR as part of the basic metabolic panel, but in 2009, the National Kidney Foundation recommended the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation to estimate the GFR. The CKD-EPI is preferred for better prediction of CKD risk and is more accurate when the GFR is normal or only mildly decreased.
D) RIFLE does not estimate GFR. Rather, because of the continuum of kidney damage that can occur in AKI and the lack of consensus on a definition, in 2004 the Acute Dialysis Quality Initiative Group developed the Risk, Injury, Failure, Loss, End-Stage Renal Disease (RIFLE) criteria to standardize the diagnosis and treatment of AKI. RIFLE stands for risk, injury, failure, loss, and ESRD.
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