Last update: July 1st, 2019.
What is Renal Cx?
Renal Cx is an iOS App based in KDIGO guidelines to calculate Renal Function with an algorithm that combines both Glomerular Filtration Rate (GFR) and Albumin-to-Creatinine Ratio (ACR).
Renal Cx is specially designed to help healthcare professionals (mainly nephrologists, but also general practitioner, intern medicine, endocrinologists or cardiovascular, among others), to know the renal status of patients thanks to the calculation of the Glomerular Filtration Rate (GFR) and the Albumin-to-Creatinine Ratio (ACR).
Glomerular Filtration Rate (GFR)
GFR is calculated from gender, race, age and serum creatinine according to the Chronic Kidney Disease Epidemiology (CKD-EPI) algorithm as recommended by the National Kidney Foundation (NKF). It is more accurate than the Modification of Diet in Renal Disease (MDRD) Study equation, particularly in people with higher levels of GFR.
Albumin-to-Creatinine Ratio (ACR)
Besides, ACR is calculated by dividing albumin concentration by creatinine concentration.
Please note ACR is the first method of preference to detect elevated amounts of urine protein (a routine dipstick is not sensitive enough to detect small amounts of urine protein).
The recommended method to evaluate albuminuria (the increased excretion of urinary albumin and a marker of kidney damage), is to measure urinary ACR in a spot urine sample.
Although the 24-hour collection has been the gold standard, alternative methods for detecting protein excretion, such as urinary ACR, correct variations in urinary concentration due to hydration as well as provide more convenience than timed urine collections. The spot specimen correlates well with 24-hour collections in adults.
Kidney Disease Improving Global Outcomes (KDIGO)
Both GFR and ACR are included in Kidney Disease Improving Global Outcomes (KDIGO) Guidelines.
- KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD), Volume 7, Issue 1, July 2017.
- Uhlig K, Macleod A, Craig J, et al. Grading evidence and recommendations for clinical practice guidelines in nephrology. A position statement from Kidney Disease: Improving Global Outcomes (KDIGO) Kidney Int. 2006;70:2058–2065.
- Ketteler M, Elder GJ, Evenepoel P, et al. Revisiting KDIGO clinical practice guideline on chronic kidney disease-mineral and bone disorder: a commentary from a Kidney Disease: Improving Global Outcomes controversies conference. Kidney Int. 2015;87:502–528.