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Estimating glomerular filtration rate (GFR) in children. The average between a cystatin C- and a creatinine-based equation improves estimation of GFR in both children and adults and enables diagnosing Shrunken Pore Syndrome

Leion, Felicia; Hegbrant, Josefine; den Bakker, Emil; Jonsson, Magnus LU ; Abrahamson, Magnus LU ; Nyman, Ulf LU ; Björk, Jonas LU ; Lindström, Veronica LU ; Larsson, Anders and Bökenkamp, Arend, et al. (2017) In Scandinavian Journal of Clinical and Laboratory Investigation
Abstract

Estimating glomerular filtration rate (GFR) in adults by using the average of values obtained by a cystatin C- (eGFRcystatin C) and a creatinine-based (eGFRcreatinine) equation shows at least the same diagnostic performance as GFR estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparison of eGFRcystatin C and eGFRcreatinine plays a pivotal role in the diagnosis of Shrunken Pore Syndrome, where low eGFRcystatin C compared to eGFRcreatinine has been associated with higher mortality in adults. The present study was undertaken to elucidate if this concept can also be applied in children. Using iohexol and inulin... (More)

Estimating glomerular filtration rate (GFR) in adults by using the average of values obtained by a cystatin C- (eGFRcystatin C) and a creatinine-based (eGFRcreatinine) equation shows at least the same diagnostic performance as GFR estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparison of eGFRcystatin C and eGFRcreatinine plays a pivotal role in the diagnosis of Shrunken Pore Syndrome, where low eGFRcystatin C compared to eGFRcreatinine has been associated with higher mortality in adults. The present study was undertaken to elucidate if this concept can also be applied in children. Using iohexol and inulin clearance as gold standard in 702 children, we studied the diagnostic performance of 10 creatinine-based, 5 cystatin C-based and 3 combined cystatin C-creatinine eGFR equations and compared them to the result of the average of 9 pairs of a eGFRcystatin C and a eGFRcreatinine estimate. While creatinine-based GFR estimations are unsuitable in children unless calibrated in a pediatric or mixed pediatric-adult population, cystatin C-based estimations in general performed well in children. The average of a suitable creatinine-based and a cystatin C-based equation generally displayed a better diagnostic performance than estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparing eGFRcystatin and eGFRcreatinine may help identify pediatric patients with Shrunken Pore Syndrome.

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epub
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keywords
Children, creatinine, cystatin C, glomerular filtration rate, humans, inulin, iohexol, kidney function tests
in
Scandinavian Journal of Clinical and Laboratory Investigation
pages
7 pages
publisher
Informa Healthcare
external identifiers
  • scopus:85019596909
  • wos:000406760700005
ISSN
0036-5513
DOI
10.1080/00365513.2017.1324175
language
English
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yes
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2c7dbc41-c228-4525-9442-3542d18e376e
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2017-06-09 08:51:50
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2017-09-24 05:11:27
@article{2c7dbc41-c228-4525-9442-3542d18e376e,
  abstract     = {<p>Estimating glomerular filtration rate (GFR) in adults by using the average of values obtained by a cystatin C- (eGFR<sub>cystatin C</sub>) and a creatinine-based (eGFR<sub>creatinine</sub>) equation shows at least the same diagnostic performance as GFR estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparison of eGFR<sub>cystatin C</sub> and eGFR<sub>creatinine</sub> plays a pivotal role in the diagnosis of Shrunken Pore Syndrome, where low eGFR<sub>cystatin C</sub> compared to eGFR<sub>creatinine</sub> has been associated with higher mortality in adults. The present study was undertaken to elucidate if this concept can also be applied in children. Using iohexol and inulin clearance as gold standard in 702 children, we studied the diagnostic performance of 10 creatinine-based, 5 cystatin C-based and 3 combined cystatin C-creatinine eGFR equations and compared them to the result of the average of 9 pairs of a eGFR<sub>cystatin C</sub> and a eGFR<sub>creatinine</sub> estimate. While creatinine-based GFR estimations are unsuitable in children unless calibrated in a pediatric or mixed pediatric-adult population, cystatin C-based estimations in general performed well in children. The average of a suitable creatinine-based and a cystatin C-based equation generally displayed a better diagnostic performance than estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparing eGFR<sub>cystatin</sub> and eGFR<sub>creatinine</sub> may help identify pediatric patients with Shrunken Pore Syndrome.</p>},
  author       = {Leion, Felicia and Hegbrant, Josefine and den Bakker, Emil and Jonsson, Magnus and Abrahamson, Magnus and Nyman, Ulf and Björk, Jonas and Lindström, Veronica and Larsson, Anders and Bökenkamp, Arend and Grubb, Anders},
  issn         = {0036-5513},
  keyword      = {Children,creatinine,cystatin C,glomerular filtration rate,humans,inulin,iohexol,kidney function tests},
  language     = {eng},
  month        = {05},
  pages        = {7},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical and Laboratory Investigation},
  title        = {Estimating glomerular filtration rate (GFR) in children. The average between a cystatin C- and a creatinine-based equation improves estimation of GFR in both children and adults and enables diagnosing Shrunken Pore Syndrome},
  url          = {http://dx.doi.org/10.1080/00365513.2017.1324175},
  year         = {2017},
}