Team:Brasil-SP/TheIssue/AvaliableSolutions

     Kidney dysfunction has been diagnosed through the evaluation of glomerular filtration rate in the kidney (GFR, measured in mL/min), in which the determination of serum creatinine concentration is the predominant method (SAKAR et al, 2005; SHLIPAK and DAY, 2013). Changes in the levels of creatinine are detectable only at later stages of renal dysfunction, when the kidney has already lost about 30% of its filtration efficiency (SHLIPAK and DAY, 2013; WASUNG et al, 2014). Moreover, the serum creatinine concentration is extremely sensitive to several variables such as diet, gender, ethnicity, age, muscle mass, and others; impairing significantly its correlation rate with the GFR (SHLIPAK and DAY, 2013; WASUNG et al, 2014). Moreover, some renal complications are asymptomatic, such as Chronic Kidney Disease (CKD), not allowing the diagnosis of the disease in its early stage (WASUNG et al, 2014). Therefore, there is a lack of tools with the precision and sensitivity needed to measure GFR in early stages of kidney disease (SHLIPAK and DAY, 2013). The urea nitrogen is also a biomarker used in the diagnosis of kidney disease, but like creatinine, it is only capable of detecting advanced stages (WASUNG et al, 2014).

References

SARKAR PD, RAJESHWARI G, SHIVAPRAKASH TM. Cystatin C - a novel marker of glomerular filtration rate. Indian Journal of Clinical Biochemistry, 2005, 20(1):139-144. doi: 10.1007/BF02893060.

SHLIPAK MG, DAY, EC. Biomarkers for incident CKD: a new framework for interpreting the literature. Nature Review on Nephrology, 2013, 9(8):478-83. doi: 10.1038/nrneph.2013.108.

WASUNG ME, CHAWLA LS, MADERO M. Biomarkers of renal function, which and when? Clinica Chimica Acta, 2014, pii:S0009-8981(14):00391-X. doi: 10.1016/j.cca.2014.08.039.