Overview: Glomerular Filtration Rate Estimated Panel
Introduction: The Glomerular Filtration Rate Estimated Panel is a diagnostic tool designed to assess kidney function using serum samples. In India, chronic kidney disease (CKD) affects ~17 percent of adults, with eGFR (calculated from creatinine, age, sex) essential for staging and early detection. High morbidity from under-testing in rural/low-SES patients with diabetes/hypertension, limited renal labs, delayed renoprotection leading to end-stage renal disease. Per nephrology practices aligned with ICMR and Indian Society of Nephrology guidelines, the test employs spectrophotometry for creatinine, eGFR, BUN over 1-2 days with high accuracy, valuable for CKD screening and monitoring. This diagnostic falls under renal function screening and targets patients with risk factors (diabetes, hypertension), addressing accurate detection to guide ACEi/ARB or dialysis referral. With elevated morbidity due to underdiagnosis, the test supports public health efforts by enabling precise GFR estimation and reducing CKD progression. Its serum-based approach ensures reliable calculation.
Other Names: GFR Pnl.
FDA Status: FDA approved, CLIA certified for biochemistry, compliant with 2025 standards.
Historical Milestone: eGFR standard; in India, used in NCD programs.
Purpose: The test assesses 3 parameters including creatinine to guide kidney function evaluation, estimate GFR, inform management.
Test Parameters: 1. Creatinine, 2. eGFR, 3. BUN.
Pretest Condition: Fasting 10-12 hours recommended; patients should report edema or risk factors.
Specimen: 3 mL serum in 1 SST, transported within specified times to maintain sample viability.
Sample Stability at Room Temperature: 8 hours with proper handling to preserve analyte integrity, ensuring reliable test performance.
Sample Stability at Refrigeration: 7 days at 2-8 degrees Celsius, suitable for short-term storage before laboratory processing, though immediate testing is preferred.
Sample Stability at Frozen: 6 months at -20 degrees Celsius, allowing long-term storage for retesting, though freezing may affect some analytes.
Medical History: Patients should provide details on diabetes, hypertension, urine output.
Consent: Written informed consent is required, detailing the test's purpose, potential risks of untreated CKD including dialysis need, benefits of early detection, and minimal discomfort from venipuncture.
Procedural Considerations: The test involves sample processing using spectrophotometry by trained personnel to ensure sterile technique, avoid hemolysis, and calculate eGFR within 1-2 days using provided controls. Laboratories must maintain a controlled environment, adhere to quality assurance protocols.
Factors Affecting Result Accuracy: Delays beyond stability periods, improper storage conditions, hemolysis, or muscle mass can affect results. Correlation with clinical evaluation or additional testing is recommended to confirm findings.
Clinical Significance: Low eGFR indicates CKD, necessitating specialist input. Normal may require follow-up in high-risk.
Specialist Consultation: Nephrologists should be consulted for management.
Additional Supporting Tests: Urine albumin/creatinine ratio for confirmation.
Test Limitations: Creatinine-based; comprehensive approach required.
References: Indian Journal of Nephrology 2024, CKD Studies India 2023.
