A 42-year-old man on ICU has an acute kidney injury. His serum creatinine is 250 µmol/L. He weighs 80 kg. His estimated GFR by the CKD-EPI equation is...

Question

A 42-year-old man on ICU has an acute kidney injury. His serum creatinine is 250 µmol/L. He weighs 80 kg. His estimated GFR by the CKD-EPI equation is reported as 25 mL/min. However, the team suspects this may underestimate his true GFR. Why might eGFR be unreliable in ICU patients?

Accepted Answer

eGFR equations (CKD-EPI, MDRD) were derived from stable chronic kidney disease populations and assume steady-state creatinine; in AKI, creatinine is rising and has not reached equilibrium, making eGFR unreliable - it typically overestimates or underestimates true GFR depending on the trajectory

Answer

eGFR equations are always accurate in ICU

Answer

eGFR is only unreliable in children

Answer

eGFR is unreliable because of high albumin in ICU

Answer

eGFR is always accurate if the laboratory uses the correct formula

uk-fficm MCQ (SBA): eGFR Limitations in AKI

A 42-year-old man on ICU has an acute kidney injury. His serum creatinine is 250 µmol/L. He weighs 80 kg. His estimated GFR by the CKD-EPI equation is reported as 25 mL/min. However, the team suspects this may underestimate his true GFR. Why might eGFR be unreliable in ICU patients?