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Misapplications of Commonly Used Kidney Equations: Renal Physiology in Practice

Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, Washington DC

Correspondence: Dr. Paul L. Kimmel, Division of Renal Diseases and Hypertension, Department of Medicine, George Washington University Medical Center, 2150 Pennsylvania Avenue NW, Washington DC 20037. Phone: 202-741-2283; Fax: 202-741-2285; E-mail: pkimmel{at}mfa.gwu.edu

Equations for estimating GFR, quantifying urinary protein excretion, and assessing renal sodium handling are widely used in routine nephrology and general medical and surgical practice. If these equations are applied in circumstances inconsistent with the clinical situations for or extrapolated beyond the limits in which they were validated, clinicians can come to erroneous conclusions, which could be detrimental for patient care. This review uses clinical vignettes to demonstrate some of the common pitfalls that clinicians may encounter in the use of these equations and considers the physiologic principles underlying their use. Equations for assessing aspects of renal function should only be used in specific clinical situations, if the underlying assumptions regarding their calculations and values are satisfied.