and it is now established as a major independent contributor to mortality. Serum

creatinine is known to be an inaccurate reflection of the presence or development

of chronic kidney disease. Since urologists frequently treat patients with coexistent

chronic kidney disease, we reviewed the merits and limitations of the current

methods to estimate renal function, and recent data indicating the importance of

optimizing renal function during treatment.

evaluate the laboratory, computational and imaging techniques for renal function

estimation.

(1.4 mg/dl or less) have chronic kidney disease based on an estimated glomerular

Foundation currently recommends using a creatinine based estimate of glomerular

filtration rate (eg Modification of Diet in Renal Disease formula) and has

advocated a standardized classification for chronic kidney disease. Chronic kidney

disease has been independently related to morbid cardiac events and all

cause mortality in a dose dependent fashion, even after controlling for a variety

of potentially confounding factors such as hypertension and diabetes. Many

urological interventions can precipitate or exacerbate chronic kidney disease,

most notably radical nephrectomy which is greatly overused.

to diagnose chronic kidney disease and its profound implications. Estimation of

renal function is better using a serum creatinine based formula than individual

serum creatinine values. Treatment goals should not be limited to avoidance of

dialysis, but should also include greater efforts to optimize renal function in all

patients and early referral for nephrological consultation.