Estimating glomerular filtration rate in youth with obesity and type 2 diabetes: the iCARE study equation

Dart, Allison; McGavock, Jonathan; Sharma, Atul; Château, Dan; Schwartz, George J.; Blydt-Hansen, Tom

doi:10.1007/s00467-019-04250-6

Cited by 13 publications

(13 citation statements)

References 38 publications

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“…

50.7 * BSA 0.816 * ((), \begin{matrix} \frac{Height ((), cm)}{Creatinine} \\ ((), μmol / normalL) \end{matrix}) 0.405 * 0.8994 if sex = females ∣ 1 otherwise

, which was validated in this cohort 27 …”

Section: Methodssupporting

confidence: 55%

“…The strengths of this study include the characterization of multiple RAS markers in serum and urine of a well characterized cohort of youth with T2D and at‐risk overweight controls. The cohort has had gold standard assessments of blood pressure and proteinuria and an eGFR equation is available that has been specifically validated in this population 27 . A key limitation that warrants discussion is the cross‐sectional nature of our study and therefore the inability to evaluate the predictive nature of RAS markers over time with respect to progression of CKD.…”

Section: Discussionmentioning

confidence: 99%

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An evaluation of renin‐angiotensin system markers in youth with type 2 diabetes and associations with renal outcomes

et al. 2020

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Aims/hypothesis: Youth with type 2 diabetes (T2D) have high rates of obesity, hypertension and suboptimal glycemic control. We hypothesized that reninangiotensin system (RAS) activation is present in youth with T2D and associated with poor glycemic control and renal outcomes. Methods: Cross-sectional analysis of 183 youth with T2D and 100 controls from the Improving renal Complications in Adolescents with T2D through REsearch cohort. Diabetes youth stratified by urine albumin:creatinine ratio (ACR) < or ≥2 mg/mmol. RAS levels measured with enzyme-linked immunosorbent assay (ELISA) and enzyme activities by synthetic substrates. In T2D, levels log transformed and Tobit linear regressions evaluated for associations with hemoglobin A1c (HbA1c), mean arterial pressure (MAP), estimated glomerular filtration rate (eGFR), ACR. Results: Youth were 14 to 15 years, with diabetes duration 1.7 to 1.8 years; 21.3% albuminuria. Serum: differences in plasma renin activity (<0.0001), and angiotensin converting enzyme (ACE) activity (P = .003) in T2D vs controls. Urine: higher ACE activity and ACE2 protein/activity (all P < .0001) in T2D, higher levels in T2D with albuminuria. Multivariable regressions: higher serum ACE activity (ß = 0.03, SE 0.01;

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“…

50.7 * BSA 0.816 * ((), \begin{matrix} \frac{Height ((), cm)}{Creatinine} \\ ((), μmol / normalL) \end{matrix}) 0.405 * 0.8994 if sex = females ∣ 1 otherwise

, which was validated in this cohort 27 …”

Section: Methodssupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

An evaluation of renin‐angiotensin system markers in youth with type 2 diabetes and associations with renal outcomes

et al. 2020

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“…It has been shown by Pottel et al [ 21 ] that the reference band for SCr/Q in children is defined by [0.67–1.33], with lower and upper limits corresponding to the 2.5th and 97.5th percentile. GFR was estimated using the following creatinine-based GFR-estimating equations, displayed in Table 1 : Height-independent full-age spectrum equation, referred to as FAS age [ 22 ]; Height-dependent full-age spectrum equation, referred to as FAS height [ 20 ]; The new European Kidney Function Consortium (EKFC) equation, referred to as EKFC [ 23 ]; Updated bedside Schwartz or CKiD equation [ 24 ]; Schwartz-Lyon equation [ 25 ]; CKiD under 25 years equation (CKiDU25) [ 26 ]; Adjusted-creatinine revised Lund-Malmö equation, referred to as LMR18 [ 27 ]; CKD-EPI equation with age-adjusted creatinine values, referred to as CKD-EPI40 [ 28 ]; Improving renal complications in Adolescents with T2D through Research equation, referred to as iCARE [ 29 ]. …”

Section: Methodsmentioning

confidence: 99%

“…L represents height in meters and SCr is expressed in mg/dL LMR18 [ 27 ] in which for females with Q < 150 µmol/L, for females with Q ≥ 150 µmol/L, for males with Q < 180 µmol/L, and for males with Q ≥ 180 µmol/L, in which Q is obtained from in males, and ; max ( Age ;18) represents the maximum of Age (actual age of the patient) and 18 years (the applied age threshold) CKD-EPI40 [ 28 ] in females with Q ≤ 62 µmol/L, in females with Q > 62 µmol/L, in males with Q ≤ 80 µmol/L, and in males with Q > 80 µmol/L, where Q represents age-adjusted creatinine (age 2–39) or actual creatinine (age ≥ 40) and max ( Age ;40) represents the maximum of actual age and 40 years. Q is obtained from in males, and in females iCARE [ 29 ] , if sex = female, | 1 otherwise); in which L represents height in cm, SCr in µmol/L Abbreviations: FAS , full-age spectrum; EKFC , European Kidney Function Consortium; CKiD , Chronic Kidney Disease in Children; CKiDU25 , CKiD under 25; LMR18 , revised Lund-Malmö extended to children; CKD-EPI40 , Chronic Kidney Disease Epidemiology Collaboration extended to children; iCARE , Improving renal complications in Adolescents with T2D through Research; SCr , serum creatinine; BSA , body surface area …”

Section: Methodsmentioning

confidence: 99%

“…-Height-dependent full-age spectrum equation, referred to as FAS height [20]; -The new European Kidney Function Consortium (EKFC) equation, referred to as EKFC [23]; -Updated bedside Schwartz or CKiD equation [24]; -Schwartz-Lyon equation [25]; -CKiD under 25 years equation (CKiDU25) [26]; -Adjusted-creatinine revised Lund-Malmö equation, referred to as LMR18 [27]; -CKD-EPI equation with age-adjusted creatinine values, referred to as CKD-EPI40 [28]; -Improving renal complications in Adolescents with T2D through Research equation, referred to as iCARE [29].…”

Section: Creatinine-based Gfr-estimating Equationsmentioning

confidence: 99%

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Creatinine-based GFR-estimating equations in children with overweight and obesity

2022

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Background With the increasing prevalence of childhood obesity and related development of chronic kidney disease (CKD), there is a critical need to understand how best to assess kidney function in children with obesity. Since serum creatinine (SCr) is recommended as marker of first choice for GFR estimation, we evaluated and compared creatinine-based GFR equations in children with overweight and obesity. Methods Six hundred children with overweight and obesity (53.5% female; mean age 12.20 ± 3.28 years; mean BMI z-score 3.31 ± 0.75) were included from the Centre for Overweight Adolescent and Children’s Healthcare (COACH). Results Serum creatinine (SCr), normalized using Q-age polynomials obtained from reference values, results in median and mean SCr/Q value close to “1” for all age groups, and 96.5% of the children have a SCr/Q within the reference band [0.67–1.33], corresponding to the 2.5th and 97.5th percentile. eGFR CKiD (bedside Schwartz equation) and Schwartz-Lyon decreased with age, whereas eGFR EKFC and modified CKD-EPI40 showed no age-dependency, but the distribution of eGFR values was not symmetrical. eGFR CKiD under 25 (CKiDU25) demonstrated no age-dependency but major sex differences were observed. eGFR FAS age, FAS height, and adjusted-creatinine revised Lund-Malmö (LMR18) showed a relatively symmetrical distribution and no age-dependency. Conclusions Serum creatinine (SCr) values of children with overweight and obesity are mostly within the reference range for children. Normalization of SCr using reference Q-age polynomials works very well in this cohort. After evaluation of the different equations, we suggest that FAS age, FAS height, and LMR18 are the preferred creatinine-based GFR-estimating equations in children with overweight and obesity. Clinical trial registration. ClinicalTrial.gov; Registration Number: NCT02091544. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

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Diabetic Kidney Disease

Dart

2023

Pediatric Kidney Disease

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Estimating glomerular filtration rate in youth with obesity and type 2 diabetes: the iCARE study equation

Cited by 13 publications

References 38 publications

An evaluation of renin‐angiotensin system markers in youth with type 2 diabetes and associations with renal outcomes

An evaluation of renin‐angiotensin system markers in youth with type 2 diabetes and associations with renal outcomes

Creatinine-based GFR-estimating equations in children with overweight and obesity

Diabetic Kidney Disease

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