Clinical Case Database / Category: Clinical Care

Assessing renal function - the eGFR explained

Publication details

Sarah Leech, Richard Fish, Karen Anthony
Foundation Years Journal, volume 5, issue 2, p.19 (123Doc Education, London, March 2011)


Mrs X is a 62-year old, white, non–insulin-dependent patient with diabetes. She was diagnosed with diabetes in 1992. Her medical history includes hypertension and asthma. She takes ramipril 5 mg daily. She is a non-smoker and does not drink alcohol. She is attending diabetic clinic for the first time. Your consultant asks you for a thorough review, including evaluation of her renal function.

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Sarah Leech

Foundation Year 1 doctor
The Whittington Hospital NHS Trust
Magdala Avenue
N19 5NF

Richard Fish

ST4 in Nephrology

Karen Anthony

Consultant in Diabetes and Endocrinology


1. Steddon S., Ashman N., Chesser A. and Cunningham J. (eds.). Clinical Assessment of the Renal Patient. Oxford Handbook of Nephrology and Hypertension, 1st edn. New York : Oxford University Press 2006; Chapter 1 pages 18–48.
2. Gul A., Gilbert S.J. and Levey A.S. Assessment of Renal Function. In: Freehally J., Floege J. and Johnson R.J. (eds.). Comprehensive Clinical Nephrology, 3rd edn. Philadelphia : Mosby Elsevier 2007; Chapter 3, pp. 27 – 34.
3. Levey A.S., Bosch J.P., Brewer L. J., Greene T., Rogers N. and Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: A new prediction equation. Ann Int Med 1999;130: 461–70.
4. Levey A.S., Coresh J., Greene T., et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Int Med 2006;145: 247–254.
5. Levey A.S., Stevens L.A., Schmid C.H. et al. A new equation to estimate glomerular filtration rate. Ann Int Med 2009; 150:604–12.
6. Bagshaw S.M. and Gibney M. Conventional markers of kidney function. Crit Care Med 2006; 36(4): 152–58.
7. Feest T. Epidemiology and causes of chronic renal failure. Medicine 35(8): 438–41.
8. National institute of clinical excellence. Chronic kidney disease: early identification and management of chronic kidney disease in adults in primary and secondary care (NICE clinical guideline 73) September 2008. Available at URL: CG073FullGuideline.pdf Accessed December 9th 2009.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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