Estimation of glomerular filtration rate from plasma creatinine concentration in children.

Counahan, R; Chantler, C; Ghazali, Sazlina Shariff; Kirkwood, Betty; Fc, Rose; Barratt, T. M.

doi:10.1136/adc.51.11.875

Cited by 283 publications

(169 citation statements)

References 8 publications

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“…The estimated GFR was used to study renal function using a modified Schwartz formula (40 Â length (in cm)/serum creatinine (in mmol/l)). 7 CRF was defined as an estimated GFR for patients of 3 months, 6 months, 1 year and more than 2 years old of o30, o44, o70 and o85 ml/min/1.73 m 2 , respectively. 8 Weekly measurement of serum creatinine was used to study renal function of the patients in the first 3 months after HSCT.…”

Section: Methodsmentioning

confidence: 99%

Long-term renal function after hemopoietic stem cell transplantation in children

Holthe

Bresters

Ahmed-Ousenkova

et al. 2005

Bone Marrow Transplant

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Summary:Glomerular function of all long-term survivors who underwent hemopoietic stem cell transplantation (HSCT) from 1991 to 1998 (study I, n ¼ 121) was studied retrospectively. In addition, we prospectively analyzed glomerular and tubular function of all long-term surviving children who received an HSCT between 1998 and 2000 (study II, n ¼ 41). We found a lower prevalence of children with chronic renal failure (CRF) post-HSCT in our more recent cohort (study II: 10%) as compared to the older cohort (study I: 24%) 5.0 (0.7 s.d.) and 7.6 (2.4 s.d.) year's post-HSCT, respectively. Furthermore, it seems that renal function may stabilize after 1-year post-HSCT. None of the patients required dialysis or antihypertensive medication at long-term follow-up. The sole predictor of CRF in our study was high serum creatinine pre-HSCT (P ¼ 0.007), while acute renal failure within 3 months after HSCT (P ¼ 0.08) only showed a trend towards predicting CRF. We could not confirm a relation of conditioning with irradiation with CRF post-HSCT, as was shown in several other pediatric and adult studies. Proximal and distal tubular dysfunction only occurred in a minority of long-time survivors of HSCT (3-12 and 9-13%, respectively) and had no clinical consequences. Hemopoietic stem cell transplantation (HSCT) has evolved as an accepted treatment modality for a diverse spectrum of diseases in children such as hematological malignancies, bone marrow failure syndromes, immunodeficiencies and inborn errors of metabolism. The 5-year survival rates depend on the disease for which HSCT is performed and vary from 90% for immunodeficiencies to 25% for highrisk hematological malignancies. 1 As long-term survival has improved over the years, assessment of late complications becomes increasingly important. Chronic renal failure (CRF) following allogeneic HSCT is reported in children, although data on incidence and etiology in long-term survivors of HSCT are still scarce. 2,3 Understanding of the possible risk factors and the pathogenesis of acute and chronic renal failure after HSCT is required in order to reduce its incidence. We have previously shown a prevalence of 28% CRF in children 1-year post-HSCT in a retrospective study, and more recently a lower prevalence of only 11% in a prospective study. 4,5 In the current study, we investigated how renal function of these patients evolved after an extended follow-up period. Patients and methods

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Section: Methodsmentioning

confidence: 99%

Long-term renal function after hemopoietic stem cell transplantation in children

Holthe

Bresters

Ahmed-Ousenkova

et al. 2005

Bone Marrow Transplant

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“…We compared the estimating equations generated using the CKiD data with published Scr-based estimating equations by Counahan et al 2 and Leger et al, 35 with cystatin C-based equations by Filler et al 36 and Grubb et al, 27 and with Scr-and cystatin C-based equations by Bouvet et al 20 and Zapitelli et al 21 using the originally published formulas and then by modifying the constants and coefficients in the published formulas after fitting them to the CKiD data. Applying each of these equations to the test group of 168 children, we determined the amount of bias from measured iGFR, 95% limits of agreement, correlation, and the percentage of estimates within 30 and 10% of measured iGFR.…”

Section: Comparison With Published Estimating Equationsmentioning

confidence: 99%

“…GFR is the most useful indicator of kidney function and kidney disease progression; however, determination of true GFR is time-consuming, costly, and difficult to perform for regular clinical use in children. Thus, there is considerable interest in developing formulas to estimate GFR using endogenous surrogate markers such as creatinine 1,2 or the low molecular weight protein cystatin C. [3][4][5] The Schwartz formula, devised for children in the mid1970s, 1,6 estimates GFR from an equation that uses serum creatinine (Scr), height, and an empirical constant. 1,2,6 GFR as estimated by the Schwartz formula has been used as one of the enrollment criteria for the Chronic Kidney Disease in Children (CKiD) study, an National Institutes of Health-funded North American cohort study whose goal is to recruit children and adolescents with mild to moderate chronic kidney disease (CKD) and characterize progression and the effects of CKD on cardiovascular, growth, and behavioral indices.…”

mentioning

confidence: 99%

New Equations to Estimate GFR in Children with CKD

Schwartz

Muñoz

Schneider

et al. 2009

Journal of the American Society of Nephrology

3,023

2,267

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The Schwartz formula was devised in the mid-1970s to estimate GFR in children. Recent data suggest that this formula currently overestimates GFR as measured by plasma disappearance of iohexol, likely a result of a change in methods used to measure creatinine. Here, we developed equations to estimate GFR using data from the baseline visits of 349 children (aged 1 to 16 yr) in the Chronic Kidney Disease in Children (CKiD) cohort. Median iohexol-GFR (iGFR) was 41.3 ml/min per 1.73 m 2 (interquartile range 32.0 to 51.7), and median serum creatinine was 1.3 mg/dl. We performed linear regression analyses assessing precision, goodness of fit, and accuracy to develop improvements in the GFR estimating formula, which was based on height, serum creatinine, cystatin C, blood urea nitrogen, and gender. This formula yielded 87.7% of estimated GFR within 30% of the iGFR, and 45.6% within 10%. In a test set of 168 CKiD patients at 1 yr of follow-up, this formula compared favorably with previously published estimating equations for children. Furthermore, with height measured in cm, a bedside calculation of 0.413*(height/serum creatinine), provides a good approximation to the estimated GFR formula. Additional studies of children with higher GFR are needed to validate these formulas for use in screening all children for CKD.

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“…The Counahan-Barratt formula may be slightly more suitable for GFR estimation based on serum creatinine in children (88,89) .…”

Section: Estimating Gfr Using Creatininementioning

confidence: 99%

The usefulness of cystatin C and related formulae in pediatrics

Filler

Huang

Yasin

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

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Serum creatinine does not share the properties of an ideal marker of glomerular fi ltration rate (GFR) like inulin, but continues to be the most widely used endogenous marker of GFR. In the search of a better biomarker of GFR, the small molecular weight protein cystatin C has been introduced with features more similar to that of inulin, such as constant production and no non-renal elimination. However, it has not enjoyed widespread use despite its signifi cantly improved diagnostic performance in the detection of impaired GFR and its independence of body composition. A variety of formulae based on either cystatin C or creatinine or both have been developed to estimate GFR. We summarize the currently used methods of GFR measurement, their limitations and analytical errors. The review also summarizes the history, features and the feasibility of cystatin C measurements as well as the most widely used formulae for the estimation of GFR in children. The diagnostic performance of the cystatin C derived eGFR formulae at various levels of GFR is also discussed. An eGFR formula derived from pooled studies analyzing both creatinine and cystatin C, and using a biology-based mathematical approach may be advantageous.

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Estimation of glomerular filtration rate from plasma creatinine concentration in children.

Cited by 283 publications

References 8 publications

Long-term renal function after hemopoietic stem cell transplantation in children

Long-term renal function after hemopoietic stem cell transplantation in children

New Equations to Estimate GFR in Children with CKD

The usefulness of cystatin C and related formulae in pediatrics

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