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Accurate eGFR reporting for children without anthropometric data

den Bakker, Emil; Gemke, Reinoud; van Wijk, Joanna A.E.; Hubeek, Isabelle; Stoffel-Wagner, Birgit; Grubb, Anders LU and Bökenkamp, Arend (2017) In Clinica Chimica Acta 474. p.38-43
Abstract

Introduction Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. Aim To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data. Methods Retrospective analysis of 408 pediatric inulin clearance studies with simultaneous height, creatinine, cystatin C and urea measurements. eGFR calculation using the... (More)

Introduction Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. Aim To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data. Methods Retrospective analysis of 408 pediatric inulin clearance studies with simultaneous height, creatinine, cystatin C and urea measurements. eGFR calculation using the recalibrated Schwartzcrea (height-dependent), FASage (height-independent) and the Schwartzcys equation. The means (Schwartzcrea + Schwartzcys) / 2 and (FASage + Schwartzcys) / 2 were compared with the CKiD3 equation incorporating cystatin C, creatinine, urea, height and gender in terms of %prediction error and accuracy. Results All three single parameter equations performed similarly (P30 accuracy around 80%). (FASage + Schwartzcys) / 2 (P30 89.2%) and (Schwartzcrea + Schwartzcys) / 2 (P30 89.0%), performed comparably to CKiD3 (P30 90.0%). If the difference between the creatinine- and the cystatine C based eGFR was < 40%, P30 accuracy of the mean exceeded 90%. Conclusion Combining the height-independent FASage and SchwartzCys equations substantially improves accuracy and performs comparably to height-dependent equations. This allows laboratories to directly report eGFR in children.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Children, Creatinine, Cystatin C, Estimated GFR, Heightindependent
in
Clinica Chimica Acta
volume
474
pages
38 - 43
publisher
Elsevier
external identifiers
  • scopus:85029102137
  • wos:000413616100007
ISSN
0009-8981
DOI
10.1016/j.cca.2017.09.004
language
English
LU publication?
yes
id
54cbb881-4e05-4283-83b7-49d10c0a618b
date added to LUP
2017-10-06 10:26:57
date last changed
2018-04-08 05:01:15
@article{54cbb881-4e05-4283-83b7-49d10c0a618b,
  abstract     = {<p>Introduction Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. Aim To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data. Methods Retrospective analysis of 408 pediatric inulin clearance studies with simultaneous height, creatinine, cystatin C and urea measurements. eGFR calculation using the recalibrated Schwartz<sub>crea</sub> (height-dependent), FASage (height-independent) and the Schwartz<sub>cys</sub> equation. The means (Schwartz<sub>crea</sub> + Schwartz<sub>cys</sub>) / 2 and (FASage + Schwartz<sub>cys</sub>) / 2 were compared with the CKiD3 equation incorporating cystatin C, creatinine, urea, height and gender in terms of %prediction error and accuracy. Results All three single parameter equations performed similarly (P<sub>30</sub> accuracy around 80%). (FASage + Schwartz<sub>cys</sub>) / 2 (P<sub>30</sub> 89.2%) and (Schwartz<sub>crea</sub> + Schwartz<sub>cys</sub>) / 2 (P<sub>30</sub> 89.0%), performed comparably to CKiD3 (P<sub>30</sub> 90.0%). If the difference between the creatinine- and the cystatine C based eGFR was &lt; 40%, P<sub>30</sub> accuracy of the mean exceeded 90%. Conclusion Combining the height-independent FASage and Schwartz<sub>Cys</sub> equations substantially improves accuracy and performs comparably to height-dependent equations. This allows laboratories to directly report eGFR in children.</p>},
  author       = {den Bakker, Emil and Gemke, Reinoud and van Wijk, Joanna A.E. and Hubeek, Isabelle and Stoffel-Wagner, Birgit and Grubb, Anders and Bökenkamp, Arend},
  issn         = {0009-8981},
  keyword      = {Children,Creatinine,Cystatin C,Estimated GFR,Heightindependent},
  language     = {eng},
  month        = {11},
  pages        = {38--43},
  publisher    = {Elsevier},
  series       = {Clinica Chimica Acta},
  title        = {Accurate eGFR reporting for children without anthropometric data},
  url          = {http://dx.doi.org/10.1016/j.cca.2017.09.004},
  volume       = {474},
  year         = {2017},
}