Rho/Rho-kinase and C-reactive protein relationship in hypertension and atherosclerosis

‘corrective formulas’ as advocated in the literature to ‘adjust’ creatinines for use in the MDRD formula in our article. It appears that this so-called ‘improvement’ only leads to even more biased results if inapt formulae are used for correction. This is at the end of the conclusions of our article. It is maybe good that this point is stressed again, and even better emphasized in this letter. Dr Delanaye and colleagues also point to some recent developments in this field, as proposed by Levey et al. at the recent ASN meeting. I fully agree that isotope dilution mass spectrometry-referenced or traceable determinations of creatinine can improve standardization, but that it remains to be proven whether the MDRD population is ‘broad enough’ to serve as a reference population for patients in CKD stage 1 or 2, and whether Jaffé-based creatinine determinations are reliable enough in these patients. Whereas, it is clear that enormous progress has been made in this field over the last two years, to a great extent attributable to the actions of the KDIGO initiative, it is also clear that a long road lies ahead before we dispose of a simple, reliable and cheap tool to detect patients at risk for decreased renal function.