1. Kreatinine Verklaard !? Introductie

2. At what level of creatinine does a 65-year-old diabetic, hypertensive white woman weighing 50 kilograms have chronic kidney disease (CKD)? > 83 µmol/L? > 133 µmol/L? > 177 µmol/L?

3. At what level of creatinine does a 65-year-old diabetic, hypertensive white woman weighing 50 kilograms have chronic kidney disease (CKD)? 77% of physicians said: Creatinine > 133 µmol/L (> 1.5 mg/dL) Actual eGFR at this creatinine = 37 mL/min/1.73m 2

4. At what level of creatinine does a 65-year-old diabetic, hypertensive white woman weighing 50 kilograms have chronic kidney disease (CKD)? 77% of physicians said: Creatinine > 133 µmol/L (> 1.5 mg/dL) Actual eGFR at this creatinine = 37 mL/min/1.73m 2 Creatinine = 83 µmol/L (0.94mg/dL) eGFR= 60 mL/min/1.73m 2

5. Relationship of Serum Creatinine to Inulin Clearance 0 20 40 60 80 100 120 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0 Inulin Clearance, mL/min/1.73 m 2 Serum Creatinine, mg/dL Area denotes normal S Cr with decreased inulin clearance 133 µmol/L GFR low normal limit SCr upper normal limit

6. Less than 20% of people with CKD are aware they have the disease 50 % 40 % 30 % 20 % 10 % 17.9 % 2.9 % 0 % Female Male Coresh, 2003 Why? creatinine reference interval does not easily correlate with GFR