Cystatin C and renal function in pediatric kidney transplant recipients

Franco, M.C.P.; Nagasako, S.S.; Machado, P.G.; Nogueira, P.C.K.; Pestana, J.O.M.; Sesso, R.

doi:10.1590/s0100-879x2009007500003

Cited by 3 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some equations performed better at low mGFR levels and others at high mGFR levels. Franco et al (28) reported superiority of the CystC-based Zappitelli equation over a PCr-based equation in 50 pediatric kidney transplant recipients, but these authors used the previous Schwartz equation established in 1976 (15,29).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Souza¹,

Cochat²,

Rabilloud³

et al. 2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objective The knowledge of renal function is crucial for the management of pediatric kidney transplant recipients. In this population, the most commonly used plasma creatinine (PCr)-based or cystatin C (CystC)-based GFR-predicting formulas may underperform (e.g., corticosteroids and trimethoprim may affect PCr concentration, whereas prednisone and calcineurin inhibitors may affect CystC concentration). This study evaluated the performance of six formulas in pediatric kidney transplant recipients.Design, setting, participants, & measurements The study used PCr-based formulas (bedside Schwartz, SchwartzLyon), CystC-based formulas (Hoek, Filler), and combined PCr-CystC-based formulas (CKD in Children [CKiD] 2012 and Zappitelli). The performance of these formulas was compared using inulin clearance as reference and assessed according to CKD stages in a historical cohort that included 73 pediatric kidney transplant recipients (199 measurements). The ability of the formulas to identify GFRs,60, ,75, and ,90 ml/min per 1.73 m 2 was assessed.Results At measured GFR (mGFR) $90 ml/min per 1.73 m 2 (nine patients; 23 measurements), the Zappitelli formula had the highest 30% accuracy (P30) (95% [95% confidence interval (95% CI), 87% to 100%]) and the bedside Schwartz had the highest 10% accuracy (P10) (56% [95% CI, 32% to 72%]). At mGFR$60 and ,90 ml/min per 1.73 m 2 (22 patients; 91 measurements), all formulas had P30 values .80%. However, only the CKiD 2012 formula had a P10 value .50%. At mGFR,60 ml/min per 1.73 m 2 (42 patients; 85 measurements), the CKiD 2012 and Schwartz-Lyon formulas had the highest P10 (45% [95% CI, 34% to 55%] and 43% [95% CI, 33% to 54%]) and P30 (90% [95% CI, 84% to 97%] and 91% [95% CI, 86% to 98%]). All studied equations except Hoek and Filler had areas under the receiver-operating characteristic curves significantly .90% in discriminating patients with renal dysfunction at various CKD stages (GFR,60, ,75, and ,90 ml/min per 1.73 m 2 ).Conclusions In pediatric kidney transplant recipients, the CKiD 2012 formula had the best performance at mGFRs,90 ml/min per 1.73 m 2 . CystC-based formulas were not superior to PCr-based formulas.

show abstract

Section: Discussionmentioning

confidence: 99%

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Souza¹,

Cochat²,

Rabilloud³

et al. 2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…In our study, we cannot assess the accuracy of the mSchwartz GFR and CKiD GFR as we did not compare the GFR estimates with isotope GFR or other gold standard GFR tests. However, in view of a high prevalence of CKD complications (using original Schwartz formula) in children post‐Tx (16–19), it seems that an estimate of GFR yielding a more conservative/lower GFR, such as the CKiD GFR, would be more beneficial in clinical practice as it would detect the decline in renal function earlier in follow‐up and allow for intervention.…”

Section: Discussionmentioning

confidence: 99%

Intraindividual variability of the modified Schwartz and novel CKiD GFR equations in pediatric renal transplant patients

Tsampalieros

Lepage

Feber

2011

Pediatric Transplantation

View full text Add to dashboard Cite

GFR in children can be obtained from a formula using SCr and height or various formulas including serum CysC. Recently, two new GFR formulas have been developed: (i) height and SCr-mSchwartz GFR and (ii) height, SCr, CysC, and serum urea (CKiD GFR). While these formulas proved to be accurate when compared to the gold standard, their use in children post-kidney Tx is yet to be assessed. A total of 1174 blood samples (urea, SCr and CysC) were analyzed from the post-Tx period in 24 Tx children (12 boys, median age = 8.6 yr) currently followed at our institution. CKiD GFR and mSchwartz GFR were compared using Bland-Altman analysis and the CV. The mSchwartz GFR overestimated the CKiD GFR (mean bias = 1.09 ± 0.14; 95% limits of agreements from 0.82 to 1.36). Median CV of CKiD GFR (10.3%) was significantly lower than that of mSchwartz GFR (15.0%), p = 0.04, and negatively correlated with the slope of GFR (r(2) = 0.34, p = 0.0026). In conclusion, CKiD GFR has a significantly lower intraindividual variation than mSchwartz GFR and may be better suited for longitudinal follow-up of patients post-Tx.

show abstract

Iothalamate versus estimated GFR in a Hispanic-dominant pediatric renal transplant population

et al. 2013

View full text Add to dashboard Cite

show abstract

Cystatin C and renal function in pediatric kidney transplant recipients

Cited by 3 publications

References 13 publications

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Accuracy of Different Equations in Estimating GFR in Pediatric Kidney Transplant Recipients

Intraindividual variability of the modified Schwartz and novel CKiD GFR equations in pediatric renal transplant patients

Iothalamate versus estimated GFR in a Hispanic-dominant pediatric renal transplant population

Contact Info

Product

Resources

About