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The Importance of Correct Protein Concentration for Kinetics and Affinity Determination in Structure-function Analysis
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Body mass does not have a clinically relevant effect on cystatin C eGFR in children

Ajay P Sharma1, Anusha Kathiravelu, Renisha Nadarajah

  • 1Department of Paediatrics, Division of Paediatric Nephrology, Children's Hospital, London Health Science Centre, University of Western Ontario, London, Canada.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|September 13, 2008
PubMed

Insights

Body mass has minimal impact on Cystatin C estimated glomerular filtration rate (eGFR) in children. Adjusting for body mass index (BMI) z-score did not improve the accuracy of Cystatin C eGFR in pediatric kidney disease patients.

Area of Science:

  • Pediatric Nephrology
  • Biomarkers in Kidney Disease
  • Renal Function Assessment

Background:

  • Cystatin C (CysC) is considered independent of body composition in pediatric populations.
  • Recent adult studies suggest body mass adjustment improves CysC-based estimated glomerular filtration rate (eGFR).
  • This necessitates re-evaluating CysC eGFR performance in children considering body mass.

Purpose of the Study:

  • To assess the impact of body mass on CysC eGFR in children.
  • To determine if accounting for body mass index (BMI) z-score improves CysC eGFR accuracy in pediatric patients with kidney diseases.

Main Methods:

  • Studied 240 children (ages 2-17.9 years) with various kidney diseases.
  • Assessed the relationship between (99)Tc DTPA GFR and CysC eGFR.
  • Calculated BMI z-score adjusted for height and age to account for growth retardation.

Main Results:

  • CysC eGFR showed no significant correlation with BMI z-score (r=0.06, P=0.34).
  • Accounting for BMI z-score did not improve the 65% variance explained by CysC eGFR or alter the regression coefficient (0.85).
  • Bland & Altman analysis revealed no improvement in bias (0.05) or standard deviation (20.39) after adjustment.

Conclusions:

  • Body mass has a minimal effect on the performance of CysC eGFR estimation in children.
  • Current CysC eGFR formulas are sufficiently accurate in pediatric populations without specific body mass adjustments.
Abstract

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