Accurate eGFR reporting for children without anthropometric data
(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
- den Bakker, Emil ; Gemke, Reinoud ; van Wijk, Joanna A.E. ; Hubeek, Isabelle ; Stoffel-Wagner, Birgit ; Grubb, Anders LU and Bökenkamp, Arend
- organization
- publishing date
- 2017-11-01
- 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
- pmid:28887027
- 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
- 2024-07-08 02:16:48
@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 < 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}}, keywords = {{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}}, doi = {{10.1016/j.cca.2017.09.004}}, volume = {{474}}, year = {{2017}}, }