Which of the following is the most accurate method to assess decline in GFR during initial stages of Renal insufficiency
Correct Answer: Creatinine Clearance
Description: Answer is B (Creatinine Clearance): Creatinine clearance is the most accurate estimation of decline in GFR amongst the option provided. Creatinine clearance is the most accurate endogenous marker for estimation of GFR to assess renal function 'Assessment of GFR is the single most impoant test of renal function in clinical practice'-Diseases of Kidney & Urinary Tract Creatinine clearance is the most accurate endogenous marker for estimation of GFR to assess renal function. Inulin is an exogenous marker that is freely faltered by the kidneys without undergoing any metabolism, tubular secretion and /or reabsorption. Inulin is thus rapidly excreted in urine by glomerular filtration and `Inulin clearance' has remained the Gold standard for estimation of GFR. Estimation of serum creatinine is the most widely used measure to assess renal function but is not the most accurate. Serum creatinine is not an accurate enough measure of renal function and can be normal in initial stages of renal failure. 'In early renal disease, however GFR can decrease substantially without changes in serum creatinine. The serum creatinine does not significantly change until the creatinine clearance is less than 70 ml/min /1.73m2 The Chemotherapy Source Book 4th (Lippincott Williams) / 224 Serum creatinine estimation is more accurate than estimation of serum urea or serum BUN in assessing renal functio
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