Human renal function maturation: a quantitative description using weight and postmenstrual age
Rhodin, Malin M. ; Anderson, Brian J. ; Peters, A. Michael ; Coulthard, Malcolm G. ; Wilkins, Barry ; Cole, Michael ; Chatelut, Etienne ; Grubb, Anders LU
; Veal, Gareth J.
and Keir, Michael J.
, et al.
(2009)
In Pediatric Nephrology
24(1).
p.67-76
- Abstract
- This study pools published data to describe the increase in glomerular filtration rate (GFR) from very premature neonates to young adults. The data comprises measured GFR (using polyfructose, Cr-51-EDTA, mannitol or iohexol) from eight studies (n=923) and involved very premature neonates (22 weeks postmenstrual age) to adulthood (31 years). A nonlinear mixed effects approach (NONMEM) was used to examine the influences of size and maturation on renal function. Size was the primary covariate, and GFR was standardized for a body weight of 70 kg using an allometric power model. Postmenstrual age (PMA) was a better descriptor of maturational changes than postnatal age (PNA). A sigmoid hyperbolic model described the nonlinear relationship... (More)
- This study pools published data to describe the increase in glomerular filtration rate (GFR) from very premature neonates to young adults. The data comprises measured GFR (using polyfructose, Cr-51-EDTA, mannitol or iohexol) from eight studies (n=923) and involved very premature neonates (22 weeks postmenstrual age) to adulthood (31 years). A nonlinear mixed effects approach (NONMEM) was used to examine the influences of size and maturation on renal function. Size was the primary covariate, and GFR was standardized for a body weight of 70 kg using an allometric power model. Postmenstrual age (PMA) was a better descriptor of maturational changes than postnatal age (PNA). A sigmoid hyperbolic model described the nonlinear relationship between GFR maturation and PMA. Assuming an allometric coefficient of 3/4, the fully mature (adult) GFR is predicted to be 121.2 mL/min per 70 kg [95% confidence interval (CI) 117-125]. Half of the adult value is reached at 47.7 post-menstrual weeks (95% CI 45.1-50.5), with a Hill coefficient of 3.40 (95% CI 3.03-3.80). At 1-year postnatal age, the GFR is predicted to be 90% of the adult GFR. Glomerular filtration rate can be predicted with a consistent relationship from early prematurity to adulthood. We propose that this offers a clinically useful definition of renal function in children and young adults that is independent of the predictable changes associated with age and size. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1374829
- author
- Rhodin, Malin M.
; Anderson, Brian J.
; Peters, A. Michael
; Coulthard, Malcolm G.
; Wilkins, Barry
; Cole, Michael
; Chatelut, Etienne
; Grubb, Anders
LU
; Veal, Gareth J.
and Keir, Michael J.
, et al. (More)
- Rhodin, Malin M.
; Anderson, Brian J.
; Peters, A. Michael
; Coulthard, Malcolm G.
; Wilkins, Barry
; Cole, Michael
; Chatelut, Etienne
; Grubb, Anders
LU
; Veal, Gareth J.
; Keir, Michael J.
and Holford, Nick H. G.
(Less)
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Renal function, Postmenstrual age, Lean body weight, Glomerular filtration rate, Body composition, Allometry, Fat-free mass
- in
- Pediatric Nephrology
- volume
- 24
- issue
- 1
- pages
- 67 - 76
- publisher
- Springer
- external identifiers
-
- wos:000263064300010
- scopus:59849122627
- pmid:18846389
- ISSN
- 1432-198X
- DOI
- 10.1007/s00467-008-0997-5
- language
- English
- LU publication?
- yes
- id
- 15bb8945-72b8-4bf4-b7a2-afd27f2aa67f (old id 1374829)
- date added to LUP
- 2016-04-01 13:36:00
- date last changed
- 2023-03-27 22:46:20
@article{15bb8945-72b8-4bf4-b7a2-afd27f2aa67f,
abstract = {{This study pools published data to describe the increase in glomerular filtration rate (GFR) from very premature neonates to young adults. The data comprises measured GFR (using polyfructose, Cr-51-EDTA, mannitol or iohexol) from eight studies (n=923) and involved very premature neonates (22 weeks postmenstrual age) to adulthood (31 years). A nonlinear mixed effects approach (NONMEM) was used to examine the influences of size and maturation on renal function. Size was the primary covariate, and GFR was standardized for a body weight of 70 kg using an allometric power model. Postmenstrual age (PMA) was a better descriptor of maturational changes than postnatal age (PNA). A sigmoid hyperbolic model described the nonlinear relationship between GFR maturation and PMA. Assuming an allometric coefficient of 3/4, the fully mature (adult) GFR is predicted to be 121.2 mL/min per 70 kg [95% confidence interval (CI) 117-125]. Half of the adult value is reached at 47.7 post-menstrual weeks (95% CI 45.1-50.5), with a Hill coefficient of 3.40 (95% CI 3.03-3.80). At 1-year postnatal age, the GFR is predicted to be 90% of the adult GFR. Glomerular filtration rate can be predicted with a consistent relationship from early prematurity to adulthood. We propose that this offers a clinically useful definition of renal function in children and young adults that is independent of the predictable changes associated with age and size.}},
author = {{Rhodin, Malin M. and Anderson, Brian J. and Peters, A. Michael and Coulthard, Malcolm G. and Wilkins, Barry and Cole, Michael and Chatelut, Etienne and Grubb, Anders and Veal, Gareth J. and Keir, Michael J. and Holford, Nick H. G.}},
issn = {{1432-198X}},
keywords = {{Renal function; Postmenstrual age; Lean body weight; Glomerular filtration rate; Body composition; Allometry; Fat-free mass}},
language = {{eng}},
number = {{1}},
pages = {{67--76}},
publisher = {{Springer}},
series = {{Pediatric Nephrology}},
title = {{Human renal function maturation: a quantitative description using weight and postmenstrual age}},
url = {{http://dx.doi.org/10.1007/s00467-008-0997-5}},
doi = {{10.1007/s00467-008-0997-5}},
volume = {{24}},
year = {{2009}},
}