What question did this study set out to answer?

To evaluate existing and emerging glomerular filtration markers and their clinical significance in measuring kidney function.

April 19, 2026

Glomerular Filtration Markers: Current and Emerging Insights

Puntos clave

To evaluate existing and emerging glomerular filtration markers and their clinical significance in measuring kidney function.
Review of current literature on glomerular filtration markers.
Comparison of measured GFR (mGFR) and estimated GFR (eGFR) methods.
Discussion on the limitations and complexities of current filtration marker assessments.
Identified both mGFR and eGFR have limitations that affect accuracy in clinical settings.
Highlighted the complexities involved in mGFR procedures and errors in eGFR due to non-GFR determinants.
Discussed potential new exogenous and endogenous markers that could improve GFR assessments.

Resumen

Glomerular filtration markers are exogenous or endogenous solutes that are eliminated from the circulation primarily by glomerular filtration. Their rate of elimination is directly related to the glomerular filtration rate (GFR), and their plasma concentration is inversely related to the GFR. GFR cannot be measured directly in humans, but it can be assessed by using filtration markers – either as measured GFR (mGFR) from clearance measurements using exogenous filtration markers (such as iothalamate and iohexol), or as estimated GFR (eGFR) from estimating equations using plasma concentrations of endogenous filtration markers (metabolites, such as creatinine, and low molecular weight proteins, such as cystatin C). Thus, both mGFR and eGFR may differ from true GFR, and understanding the physiologic processes affecting filtration markers is required for clinical evaluation of GFR. Processes other than GFR that affect the plasma concentration of filtration markers are collectively defined as non-GFR determinants. By design, exogenous filtration markers are minimally affected by non-GFR determinants, but both urinary and plasma clearance measurements are associated with error in mGFR. In contrast, by definition, all endogenous filtration markers are affected by non-GFR determinants, but not by error in clearance measurements. The major limitations of mGFR procedures are complexity and inconvenience of clearance measurements, which constrain their utility in clinical practice. The major limitation of eGFR is error due to variation in the non-GFR determinants of the filtration markers, which can be minimized by use of a panel of markers (panel eGFR). There is ongoing interest in the discovery of new exogenous filtration markers that would enable widespread implementation of mGFR procedures and novel metabolite and low molecular weight endogenous filtration markers that would enable a panel eGFR. In this Review, we discuss current and emerging insights into existing and novel filtration markers.

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Cite This Study

Levey et al. (Fri,) studied this question.

synapsesocial.com/papers/69e47321010ef96374d8f0fb https://doi.org/https://doi.org/10.2215/cjn.0000001090

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