The Lund-Malmo creatinine-based glomerular filtration rate prediction equation for adults also performs well in children

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Abstract

Objective . To evaluate the clinical performance in a paediatric population of the Lund-Malmo creatinine-based glomerular filtration rate (GFR) prediction equations, primarily developed for adults. Material and methods . Iohexol clearance was used as the gold standard in 85 paediatric Caucasian patients (0.3-17 years; 37 F/48 M). One Lund-Malmo equation was based on age and gender (LM) and one included lean body mass (LM-LBM). Comparisons focused on correlation (adjusted R-2), bias (median percent error) and accuracy (proportions of predicted GFR differing <= 30 % from measured GFR) (mL/min/1.73 m(2)). The performances were compared with those of the Modification of Diet in Renal Disease (MDRD) Study equation, a dedicated paediatric creatinine equation, Counahan-Barratt (CB) and a cystatin C-based equation. Results . The MDRD equation performed poorly with a median bias of 96 %. Of the remaining equations, only the LM-LBM produced significant bias (+10 % in median) according to line of identity regression analysis. The LM equation yielded marginally higher accuracy (76 %) than the LM-LBM equation (74 %) and the CB (73 %), but lower than the cystatin C-based equation (82 %). However, the estimated accuracy figures for these four equations were generally imprecise and none of the differences compared with the LM equation was statistically significant. Conclusion . In contrast to most creatinine-based GFR prediction equations, the LM equation performs adequately for both children and adults. This may be due to the unique model-building principles used when the LM equation was established. Further validation in a larger paediatric population is necessary.

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Subject classification (UKÄ) – MANDATORY

  • Pharmacology and Toxicology
  • Environmental Health and Occupational Health
  • Radiology, Nuclear Medicine and Medical Imaging
  • Medicinal Chemistry

Keywords

  • kidney, kidney disease, Drug therapy, glomerular filtration rate, function tests, renal insufficiency
Original languageEnglish
Pages (from-to)568-576
JournalScandinavian Journal of Clinical & Laboratory Investigation
Volume68
Issue number7
Publication statusPublished - 2008
Publication categoryResearch
Peer-reviewedYes