Extending the cystatin C based EKFC-equation to children – validation results from Europe

Hans Pottel, Ulf Nyman, Jonas Björk, Ulla Berg, Arend Bökenkamp, Laurence Derain Dubourg, Sandrine Lemoine, Karolien Goffin, Anders Grubb, Magnus Hansson, Anders Larsson, Karin Littmann, Kajsa Åsling-Monemi, Khosrow Adeli, Etienne Cavalier, Pierre Delanaye

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskriftPeer review


Background: A new cystatin C based European Kidney Function Consortium (EKFCCysC) equation was recently developed for adults, using the same mathematical form as the previously published full age spectrum creatinine based EKFC-equation (EKFCCrea). In the present study the cystatin C based EKFC-equation is extended to children, by defining the appropriate cystatin C rescaling factor QCysC. Methods: Rescaling factor QCysC for cystatin C was defined as: a) 0.83 mg/L, exactly as it was defined for young adults in the adult equation, and b) a more complex QCysC-age relationship based on 4th degree cystatin C-age polynomials after evaluation of data from Uppsala, Stockholm and Canada and aggregated data from Germany. The EKFCCysC equation was then validated in an independent dataset in European children (n = 2,293) with measured GFR, creatinine, cystatin C, age, height and sex available. Results: The EKFCCysC with the simple QCysC-value of 0.83 had a bias of –7.6 [95%CI –8.4;–6.5] mL/min/1.73 m2 and a P30-value of 85.8% [95%CI 84.4;87.3] equal to the EKFCCysC with the more complex 4th degree QCysC-value. The arithmetic mean of the EKFCCrea and EKFCCysC with the simple QCysC of 0.83 had a bias of –4.0 [95%CI –4.5;–3.1] mL/min/1.73 m2 and P30 of 90.4% [95%CI 89.2;91.6] similar to using the more complex 4th degree QCysC-polynomial. Conclusion: Using exactly the same QCysC of 0.83 mg/L, the adult EKFCCysC can easily be extended to children, with some bias but acceptable P30-values. The arithmetic mean of EKFCCrea and EKFCCysC results in bias closer to zero and P30 slightly over 90%. Graphical Abstract: [Figure not available: see fulltext.].

TidskriftPediatric Nephrology
StatusAccepted/In press - 2023

Bibliografisk information

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to International Pediatric Nephrology Association.

Ämnesklassifikation (UKÄ)

  • Urologi och njurmedicin


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