estimated glomerular filtration rate

Overview

Estimated glomerular filtration rate (EGFR) is a clinical metric used to approximate the kidney’s filtration capacity, based on serum biomarkers such as creatinine and, in some settings, cystatin C together with demographic variables. It is one of the most widely used indicators of renal function in routine care, particularly for chronic kidney disease (CKD), diabetes-associated kidney disease, acute kidney injury, and kidney transplant follow-up. Because it is an estimate rather than a direct measurement, EGFR is interpreted alongside urine albumin-to-creatinine ratio, serum creatinine, Blood Pressure, and clinical context.

Clinically, EGFR is central to staging kidney disease, monitoring progression, and guiding treatment decisions, including dosing of nephrotoxic or renally cleared drugs such as vancomycin and eligibility criteria in clinical trials. In recent biomedical research, EGFR has also served as a key outcome variable for evaluating renoprotective therapies such as finerenone, renin–angiotensin system blockade, glucagon-like peptide-1 receptor agonists, and glucocorticoid-based regimens, as well as a stratification variable in studies of kidney transplant recipients and diabetic kidney disease.

Focus of Latest Publications

Recent studies used EGFR primarily as a marker of kidney function stability, decline, or treatment response across nephrology and pharmacology settings. In a multicenter randomized trial of Yi-Shen-Hua-Shi granule added to supportive care for IgA nephropathy, no significant differences in EGFR were observed between groups, indicating that the intervention reduced proteinuria without measurable short-term separation in filtration function. Similarly, a real-world study of telitacicept with or without glucocorticoids in IgA nephropathy reported a slight increase in EGFR in both groups, but without a significant difference, suggesting limited detectable effect on filtration over the study period.

In diabetic kidney disease, EGFR was repeatedly used to characterize baseline risk and treatment response. A study of finerenone in CKD associated with type 2 diabetes examined whether the pre-treatment EGFR trajectory modified renoprotective benefit, emphasizing that prior kidney function decline may influence response. Another study evaluated whether an initial decline in EGFR after renin–angiotensin system blockade, together with Blood Pressure lowering, predicted later worsening of renal function in type 2 diabetes mellitus. A real-world cohort of Hispanic adults with type 2 diabetes extracted EGFR and urine albumin-to-creatinine ratio from electronic medical records to describe renal function parameters alongside glycemic control, including glycated haemoglobin A1c.

EGFR also appeared in studies of drug safety and acute kidney injury. A vancomycin case report described acute kidney injury with serum creatinine elevation and EGFR of 36.1 mL/min coinciding with a toxic trough concentration, illustrating how EGFR is used to quantify renal impairment during nephrotoxic exposure. In contrast, a study of contrast-induced acute kidney injury identified EGFR among the key risk factors in an in-hospital electronic monitoring system, supporting its role in predictive modeling. Another publication on exclusion criteria in phase 3 randomized controlled trials in hematologic malignancies showed that creatinine clearance/EGFR was one of the most common renal thresholds used to exclude patients with renal impairment, underscoring its importance in trial design.

In transplant medicine, EGFR was used to assess graft function over time. A case series of glucagon-like peptide-1 receptor agonists in kidney transplant recipients reported that EGFR remained stable and even trended toward improvement, while a machine-learning study in kidney transplant recipients modeled late EGFR using numerical prediction and Monte Carlo simulation. These studies reinforce EGFR as a longitudinal endpoint for graft health and post-transplant metabolic management.

Although many of the provided publication contexts centered on epidermal growth factor receptor (EGFR) in oncology, EGFR remained relevant as a renal safety and eligibility metric in those settings as well. For example, osimertinib and other EGFR-targeted therapies were discussed in lung cancer studies, where renal function monitoring is clinically important for treatment tolerance and supportive care. The distinction between EGFR and EGFR is important: the former is a receptor tyrosine kinase target in cancer biology, whereas the latter is a kidney function metric used across nephrology, oncology, and pharmacotherapy.