glomerular filtration rate
glomerular filtration rate
Overview
Glomerular filtration rate (GFR) is a fundamental physiological measure of kidney function, reflecting the volume of plasma filtered by the glomeruli per unit time. In clinical practice, it is used to assess renal function, stage chronic kidney disease, monitor acute kidney injury, and guide eligibility, dosing, and safety decisions in many therapeutic settings. Because direct measurement is complex, GFR is often estimated using serum creatinine-based equations, including estimated glomerular filtration rate (EGFR), or measured with exogenous clearance markers in research and specialized clinical evaluation.
As a biomedical target in recent literature, GFR appears primarily as a renal function endpoint and stratification variable rather than a molecular drug target. It is frequently interpreted alongside creatinine, cystatin C, blood urea nitrogen, albuminuria, and other markers of kidney injury or progression. In studies of type 2 diabetes, chronic kidney disease, diabetic kidney disease, HIV treatment, immunosuppressive therapy, and kidney fibrosis, changes in GFR or EGFR were used to define kidney damage, predict outcomes, or evaluate treatment safety and efficacy.
Recent Publications Focus
Below is a summary of the newest research publications targeting glomerular filtration rate (sorted by publication date).
Recent studies have increasingly recognized the importance of assessing renal function through estimated glomerular filtration rate (EGFR) in the context of cancer treatment and kidney disease management. In head and neck cancer patients undergoing concurrent chemoradiotherapy with cisplatin, individualized EGFR measurements were examined to understand how baseline renal function associates with the ability to achieve cumulative cisplatin doses ≥200 mg/m², which is critical for improved treatment outcomes [42373265]. This reflects broader clinical concern that cisplatin, being primarily excreted by the kidneys, requires careful monitoring of renal function to optimize both efficacy and tolerability.
Beyond cancer therapeutics, research has focused on how acute changes in EGFR may inform the long-term clinical benefits of kidney-protective therapies. Studies applying principal stratification methods examined how acute EGFR changes following sodium-glucose cotransporter-2 inhibitor (SGLT-2i) treatment modify expected effects on clinical endpoints in patients with chronic kidney disease, addressing the statistical challenge of distinguishing treatment-induced biomarker changes from natural variability [42054403]. This approach provides a framework for understanding whether early EGFR response can predict sustained renoprotective benefits.
Complementing these clinical investigations, methodological research has advanced the technical assessment of glomerular filtration rate itself. Mannitol clearance was validated as a reliable alternative GFR marker in patients with chronic kidney disease stages 3-4, showing comparable accuracy to the reference standard iohexol clearance with multi-sample collection protocols achieving 100% accuracy (P30 and P10) and minimal bias [41930677]. Additionally, functional markers of renal capacity have been investigated; fasting urine osmolality was examined as a predictor of kidney disease progression beyond EGFR reduction and albuminuria in patients with type 2 diabetes, recognizing that tubular concentrating capacity provides complementary information about kidney structural and functional integrity [41384790].