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The mucoprotein uromodulin is considered to correlate with glomerular filtration rates (GFR) in patients with chronic kidney disease (CKD). Here we investigated how serum uromodulin is associated with measured GFR using inulin-clearance and GFR estimated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation in healthy subjects. We assessed possible correlations between uromodulin serum concentrations, inulin-GFR and CKD-EPI-GFR in a well characterized study cohort of 112 healthy living kidney donors with two kidneys before and 64 with one kidney after kidney donation. A subgroup of 32 individuals, which presented data before and after nephrectomy, was assessed separately. All 112 healthy living kidney donors with two kidneys revealed individual serum uromodulin concentrations between 60.1 and 450.5 µg/L. Sixty-four healthy kidney donors after nephrectomy had significantly lower median (interquartile range) serum uromodulin concentrations (124 [101–166] vs. 185 [152–238] µg/L), inulin-GFR (67.3 [60.6–74.6] vs. 93.5 [82.1–104.4] mL/min/1.73 m2), and CKD-EPI-GFR (61.2 [53.1–69.7] vs. 88.6 [80.0–97.1] mL/min/1.73 m2) as compared to the 112 donors before donation (p<0.001). The subgroup of 32 subjects, which presented data before and after nephrectomy, showed almost the same pattern of kidney function. No statistically relevant associations were found between serum uromodulin and inulin-GFR or CKD-EPI-GFR regarding this healthy population. These novel findings indicate that – in contrast to patients with CKD – serum uromodulin concentrations are not correlated with measured and estimated GFR in healthy individuals. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: The aim of the paper is to give insight into MOOCs in general and to specifically describe a MOOC developed in the course of the SCOPE project "Screening for Chronic Kidney Disease (CKD) among older People across Europe". Findings: The major target of the MOOC was the improvement of knowledge for a broad audience. The SCOPE MOOCs are freely accessible, structured in three modules, offer additional learning material and guarantee knowledge dissemination about aging and chronic kidney diseases. Message: The MOOCs represent a contemporary example of how modern technology is supporting a transition to modern training in geriatrics. Purpose: To cover the increasing need for professional knowledge, skills and competences in the care of older people, new learning techniques have been developed. Using the Internet to provide educational material has come into focus of many academic institutions as the learning content can easily be transferred to a larger audience. Since the first launch of a "massive open online course" (MOOC) in 2008, this educational format has raised increasing interest among education experts. The current publication provides insight into the new format of MOOCs in general and specifically describes a MOOC developed by a Pan-European Consortium "Screening for Chronic Kidney Disease (CKD) among Older People across Europe" (SCOPE), a project funded by the European Commission under the umbrella of the Horizon 2020 program. Methods: Technical background, learning theories and content of the MOOC of the SCOPE project are presented in this overview. Results: The MOOC of the SCOPE project is provided on the MOOC ICT platform iMoox. The courses are built up of video clips, textual descriptions, graphics, animations and audio designed with a clear structure and learning goals. The concise video clips with a maximum length of 15–20 min are equipped with additional learning material such as documents, links and asynchronous communication opportunities. Conclusion: MOOCs are recognized as a contemporary approach to transfer required knowledge and skills not only in general but also in geriatric medicine, as the health and social care environment is ever-changing and becoming more complex. [ABSTRACT FROM AUTHOR]

Renal clearances of suitable clearance markers such as inulin and p-aminohippurate, determined before and after protein load, have been used for a long time to determine glomerular filtration rate (GFR), renal blood-flow, renal functional reserve as well as renal vascular resistance. Despite this long history, inconsistent results were achieved in determining renal functional reserve after protein ingestion or aminoacids infusion. Most authors found acute 'blunted increases' in GFR after dietary stresses, whereas others found acute decreases. In hypertensive patients showing hyperfiltration, a contradictory situation was observed; the traditionally observed 'blunted increase' in GFR and increase in the intraglomerular pressure were neither accompanied by a change in albumin excretion nor by an expected dynamic GFR response after administration of angiotensin converting enzyme (ACE)-inhibitors. We are of the opinion that the traditional clinical methods for assessing acutely provoked changes in renal function have been inappropriate and that an approach based on the two-compartment model of pharmacokinetics is more adequate for studying dynamic clearance changes within clinically feasible time horizons. Such test evaluations performed in patients within a washout period, and after long-term treatment with various drugs enable one to assess the efficacy of the therapeutic regimens especially in patients showing apparently normal or increased baseline clearances in hyper filtering kidneys.