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Determinants of eGFR at start of renal replacement therapy in paediatric patients

Karlijn J van Stralen1, E Jane Tizard, Kitty J Jager

  • 1ESPN/ERA-EDTA Registry, Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. K.J.vanStralen@amc.uva.nl

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|April 17, 2010
PubMed

Insights

Glomerular filtration rate (GFR) in children starting renal replacement therapy (RRT) is influenced by age, gender, and treatment type. Understanding these factors is crucial for pediatric nephrology care.

Area of Science:

  • Pediatric Nephrology
  • Renal Replacement Therapy
  • Glomerular Filtration Rate

Background:

  • Limited research exists on factors affecting glomerular filtration rate (GFR) in pediatric patients initiating dialysis or transplantation.
  • Understanding GFR determinants is vital for optimizing care in children with kidney failure.

Purpose of the Study:

  • To investigate the key determinants of estimated glomerular filtration rate (eGFR) at the initiation of renal replacement therapy (RRT) in pediatric patients.
  • To identify factors influencing eGFR in children under 18 starting RRT.

Main Methods:

  • Utilized data from the European Society of Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association registry (2002-2007).
  • Included incident pediatric patients (<18 years) starting RRT across 14 European countries.
  • Calculated eGFR using the Schwartz formula and adjusted for age, gender, treatment modality, primary renal disease (PRD), and European region (eGFR(adj)).

Main Results:

  • Median eGFR at RRT initiation was 10.4 mL/min/1.73 m(2) for 938 patients.
  • Lower eGFR was associated with younger age, female gender, starting dialysis, and a shorter interval between first pediatric nephrologist visit and RRT.
  • Primary renal diseases showed varying GFR decline rates but did not impact adjusted eGFR at RRT start.

Conclusions:

  • Age, gender, treatment modality, and time to RRT are primary determinants of eGFR at RRT initiation in children.
  • Further research is necessary to understand the clinical implications of these identified GFR determinants.
Abstract

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