Comparasion of methods of examination glomerular filtration

Currently, in the world 500 million people suffer from chronic kidney disease, which means that affects roughly every tenth inhabitant of our planet. Among many causes, the most important are an increase of numbers of patients with chronic diseases, increasing life expectancy, increase of arterial hypertension, obesity and diabetes. There are many different kinds of kidney diseases, often it's the combined disturbances which are affecting multiple organs or organ systems. Early stages of chronic damage are often unrecognized. Early detection, assessment of severity and early treatment can not only slow but in some cases stop the progression of the disease and also significantly reduce life-threatening cardiovascular complication. According to a KDIGO ( Kidney Disease: Improving Global Outcome ). The basic methods includes assessment and tests of kidney function GFR ( Glomerular filtration rate). CKD ( Chronic Kidney Disease ) is divided into five categories, and it is based on their reduced function detectable by a glomerular filtration. Investigation of filtering function of the kidneys is necessary not only for it's detection and classification of chronic kidney disease, but also to assess the associated cardiovascular risk. There are methods, which we are using to determine the glomerular filtration - Direct method and increasingly the calculation methods which don't require collection of urine. In this work, I dealt with comparing methods of testing glomerular filtration. One direct method, creatinine clearance, which required accurate collection of urine for 24 hours and three calculation methods. Two methods which are dependent on creatinine serum, equation MDRD ( Modification of Diet in Renal disease) and CKD- EPI ( Chronic Kidney Disease-Epidemiology Collaboration) and one dependent on the concentration of serum of cystatin C equation CKD-EPI. In the theoretical part is briefly explained the functionality and structure of the kidney. Then I mentioned the severity and frequency of kidney disease and determined the extent of damage depending on certain factors. In this part is an overview of the methods used for determination of rate of glomerular filtration and suitability of individual methods and estimates. The practical part describes taking a samples, their analysis and principle of investigation of analyte levels from samples which are needed to determine levels of glomerular filtration. I examined 90 selected adult patients with suspected chronic kidney disease. For each one, I measured three analytes- creatinine and cystatin C in serum and urine creatinine. Measurements of creatinine serum, cystatin C and urinary creatinine, I carried on analyser ADVIA 1800 diagnostic kit from company Siemens in workplace of Clinical Chemistry of Hospital Ceske Budejovice, a.s. The results were statistically evaluated by Box- diagram, by Passing-Bablokovy regression and by Bland- Altman diagram. Assessing and compering the final data has shown that the various glomerular filtration methods are substitute for a selected group of patients with suspected chronic kidney disease and do not show a clinically significant differences. Based on this information, I confirm the hypothesis. I embraced used laboratory and investigation methods. This was the goal of my work