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Så kan formel för vuxna skatta glomerulär filtration hos barn

Nyman, Ulf LU ; Berg, Ulla ; Grubb, Anders LU orcid ; Larsson, Anders ; Hansson, Magnus ; Littmann, Karin ; Åsling-Monemi, Kajsa and Björk, Jonas LU (2021) In Lakartidningen 118.
Abstract

Age-adjustment of creatinine, i.e. recalculation of childhood levels of creatinine to corresponding levels at 18 years of age and applied in the adult revised Lund-Malmö GFR equation led to markedly improved accuracy in Swedish children (n=1 718) at measured GFR <75 mL/min/1.73 m2 (n=318) and preserved high accuracy at ≥75 mL/min/1.73 m2 (n=1 400). The adjusted LMR equation performed as well as dedicated paediatric equations based on height. The proposed adjustment strategy has four strengths: (i) the original coefficients of the adult GFR equation can be used, (ii) the same equation can be used across the entire lifespan without artificial changes in estimated GFR when switching from paediatric to adult care, (iii) the lack of... (More)

Age-adjustment of creatinine, i.e. recalculation of childhood levels of creatinine to corresponding levels at 18 years of age and applied in the adult revised Lund-Malmö GFR equation led to markedly improved accuracy in Swedish children (n=1 718) at measured GFR <75 mL/min/1.73 m2 (n=318) and preserved high accuracy at ≥75 mL/min/1.73 m2 (n=1 400). The adjusted LMR equation performed as well as dedicated paediatric equations based on height. The proposed adjustment strategy has four strengths: (i) the original coefficients of the adult GFR equation can be used, (ii) the same equation can be used across the entire lifespan without artificial changes in estimated GFR when switching from paediatric to adult care, (iii) the lack of height factor makes it easier to automatically report estimated GFR by the laboratories and (iv) age-adjusted creatinine values imply that well-established creatinine reference intervals for adults can also be used for children.

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Abstract (Swedish)
Omräkning av barns (≥2 år) kreatininvärden till motsvarande värden vid 18 års ålder och applicerade i Lund–Malmö-formeln för vuxna ledde till avsevärt förbättrad skattning av GFR bland barn vid uppmätt GFR <75, bibehållen noggrannhet ≥75 ml/min/1,73m2 och likvärdig med pediatriska formler.

Lund–Malmö-formeln kan användas under hela livet ≥2 år utan plötsliga artificiella förändringar i skattad GFR vid övergång från pediatrisk till vuxen vård.

Formeln är enklare att implementera i automatiska laboratoriesvar än pediatriska formler eftersom dessa kräver längduppgift.

Åldersjusteringen av barns kreatininvärden innebär att väletablerade referensintervall för kreatinin hos vuxna även kan användas för barn.
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author
; ; ; ; ; ; and
organization
alternative title
GFR estimation in children - age-adjusted creatinine makes the adult Lund-Malmö equation applicable in children and facilitates automatic GFR reporting from the clinical laboratory
publishing date
type
Contribution to journal
publication status
published
subject
in
Lakartidningen
volume
118
publisher
Swedish Medical Association
external identifiers
  • scopus:85108752438
  • pmid:34151996
ISSN
0023-7205
language
Swedish
LU publication?
yes
id
4bb0d8ee-86c5-4b73-bd36-05c10506f231
date added to LUP
2021-08-16 16:40:00
date last changed
2024-06-01 13:50:27
@article{4bb0d8ee-86c5-4b73-bd36-05c10506f231,
  abstract     = {{<p>Age-adjustment of creatinine, i.e. recalculation of childhood levels of creatinine to corresponding levels at 18 years of age and applied in the adult revised Lund-Malmö GFR equation led to markedly improved accuracy in Swedish children (n=1 718) at measured GFR &lt;75 mL/min/1.73 m2 (n=318) and preserved high accuracy at ≥75 mL/min/1.73 m2 (n=1 400). The adjusted LMR equation performed as well as dedicated paediatric equations based on height. The proposed adjustment strategy has four strengths: (i) the original coefficients of the adult GFR equation can be used, (ii) the same equation can be used across the entire lifespan without artificial changes in estimated GFR when switching from paediatric to adult care, (iii) the lack of height factor makes it easier to automatically report estimated GFR by the laboratories and (iv) age-adjusted creatinine values imply that well-established creatinine reference intervals for adults can also be used for children.</p>}},
  author       = {{Nyman, Ulf and Berg, Ulla and Grubb, Anders and Larsson, Anders and Hansson, Magnus and Littmann, Karin and Åsling-Monemi, Kajsa and Björk, Jonas}},
  issn         = {{0023-7205}},
  language     = {{swe}},
  month        = {{06}},
  publisher    = {{Swedish Medical Association}},
  series       = {{Lakartidningen}},
  title        = {{Så kan formel för vuxna skatta glomerulär filtration hos barn}},
  volume       = {{118}},
  year         = {{2021}},
}