Accurate eGFR reporting for children without anthropometric data

作者:den Bakker Emil*; Gemke Reinoud; van Wijk Joanna A E; Hubeek Isabelle; Stoffel Wagner Birgit; Grubb Anders; Bokenkamp Arend
来源:Clinica Chimica Acta, 2017, 474: 38-43.
DOI:10.1016/j.cca.2017.09.004

摘要

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(crea) (height-dependent), FASage (height-independent) and the Schwartz(cys) equation. The means (Schwartz(crea) + Schwartz(cys)) / 2 and (FASage + Schwartz(cys)) / 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-30 accuracy around 80%). (FASage + Schwartz(cys)) / 2 (P-30 89.2%) and (Schwartz(crea) + Schwartz(cys)) / 2 (P-30 89.0%), performed comparably to CKiD3 (P-30 90.0%). If the difference between the creatinine- and the cystatine C based eGFR was < 40%, P-30 accuracy of the mean exceeded 90%. Conclusion: Combining the height-independent FASage and Schwartz(Cys) equations substantially improves accuracy and performs comparably to height-dependent equations. This allows laboratories to directly report eGFR in children.

  • 出版日期2017-11