New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance

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New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance. / Berg, Ulla B.; Nyman, Ulf; Back, Rune; Hansson, Magnus; Monemi, Kajsa Asling; Herthelius, Maria; Björk, Jonas.

In: Pediatric Nephrology, Vol. 30, No. 8, 2015, p. 1317-1326.

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Berg, Ulla B. ; Nyman, Ulf ; Back, Rune ; Hansson, Magnus ; Monemi, Kajsa Asling ; Herthelius, Maria ; Björk, Jonas. / New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance. In: Pediatric Nephrology. 2015 ; Vol. 30, No. 8. pp. 1317-1326.

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TY - JOUR

T1 - New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance

AU - Berg, Ulla B.

AU - Nyman, Ulf

AU - Back, Rune

AU - Hansson, Magnus

AU - Monemi, Kajsa Asling

AU - Herthelius, Maria

AU - Björk, Jonas

PY - 2015

Y1 - 2015

N2 - This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin). A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m(2)). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates +/- 30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPA(CYSC) and Berg(CYSC), for creatinine equations, Schwartz(CREA) and Gao(CREA), the arithmetic mean of CAPA(CYSC) and Schwartz(CREA) (MEAN(CAPA+Schwartz)), Berg(CYSC) and Schwartz(CREA) (MEAN(BERG+SCHWARTZ)) and the composite equation Chehade(CYSC+CREA). Overall results of CAPA(CYSC), Berg(CYSC), Schwartz(CREA), Gao(CREA), MEAN(CAPA+Schwartz,) MEAN(BERG+SCHWARTZ) and Chehade(CYSC+CREA) were: median bias -7.6/-4.9/-3.7/-2.3/-4.6/-4.0/-10.1 %, IQR 20.0/19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m(2) and P30 86/86/80/83/89/91/83 %. The cystatin C equations, MEAN(CAPA+Schwartz) and MEAN(BERG+SCHWARTZ) had a more stable performance across subgroups compared with Schwartz(CREA), Gao(CREA) and Chehade(CYSC+CREA). Cystatin C was the preferred filtration marker for GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.

AB - This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin). A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m(2)). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates +/- 30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPA(CYSC) and Berg(CYSC), for creatinine equations, Schwartz(CREA) and Gao(CREA), the arithmetic mean of CAPA(CYSC) and Schwartz(CREA) (MEAN(CAPA+Schwartz)), Berg(CYSC) and Schwartz(CREA) (MEAN(BERG+SCHWARTZ)) and the composite equation Chehade(CYSC+CREA). Overall results of CAPA(CYSC), Berg(CYSC), Schwartz(CREA), Gao(CREA), MEAN(CAPA+Schwartz,) MEAN(BERG+SCHWARTZ) and Chehade(CYSC+CREA) were: median bias -7.6/-4.9/-3.7/-2.3/-4.6/-4.0/-10.1 %, IQR 20.0/19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m(2) and P30 86/86/80/83/89/91/83 %. The cystatin C equations, MEAN(CAPA+Schwartz) and MEAN(BERG+SCHWARTZ) had a more stable performance across subgroups compared with Schwartz(CREA), Gao(CREA) and Chehade(CYSC+CREA). Cystatin C was the preferred filtration marker for GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.

KW - Creatinine

KW - Cystatin C

KW - of inulin

KW - Clearance

KW - Renal dysfunction

KW - Renal function

KW - Glomerular filtration rate

U2 - 10.1007/s00467-015-3060-3

DO - 10.1007/s00467-015-3060-3

M3 - Article

C2 - 25903639

VL - 30

SP - 1317

EP - 1326

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 1432-198X

IS - 8

ER -