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Assessment of Child Anthropometry in a Large Epidemiologic Study
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Accurate eGFR reporting for children without anthropometric data.

Emil den Bakker1, Reinoud Gemke1, Joanna A E van Wijk1

  • 1Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|September 10, 2017
PubMed
Summary

Combining a height-independent creatinine equation (FASage) with a cystatin C equation (SchwartzCys) accurately estimates kidney function in children. This approach simplifies reporting for laboratories, improving pediatric eGFR assessment.

Keywords:
ChildrenCreatinineCystatin CEstimated GFRHeightindependent

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Area of Science:

  • Pediatric Nephrology
  • Clinical Chemistry
  • Biomarker Analysis

Background:

  • Current guidelines recommend reporting estimated glomerular filtration rate (eGFR) over serum concentrations.
  • Most pediatric creatinine-based eGFR equations require height, which is often unavailable to laboratories.
  • Combining height-dependent creatinine and cystatin C eGFR equations improves accuracy.

Purpose of the Study:

  • To compare the accuracy of combined height-independent creatinine and cystatin C eGFR equations with combined anthropometric-dependent equations.
  • To evaluate the performance of a novel height-independent creatinine-based eGFR equation in pediatric populations.

Main Methods:

  • Retrospective analysis of 408 pediatric inulin clearance studies.
  • Calculated eGFR using height-dependent Schwartzcrea, height-independent FASage, and Schwartzcys equations.
  • Compared the mean of combined equations ((Schwartzcrea+Schwartzcys)/2 and (FASage+Schwartzcys)/2) against the CKiD3 equation.

Main Results:

  • Single parameter equations showed similar performance (P30 accuracy ~80%).
  • Combined equations (FASage+Schwartzcys)/2 (P30 89.2%) and (Schwartzcrea+Schwartzcys)/2 (P30 89.0%) were comparable to CKiD3 (P30 90.0%).
  • Accuracy exceeded 90% when the difference between creatinine- and cystatin C-based eGFR was <40%.

Conclusions:

  • Combining the height-independent FASage and SchwartzCys equations significantly enhances eGFR accuracy in children.
  • This combined approach performs comparably to height-dependent equations.
  • Enables direct eGFR reporting by laboratories for pediatric patients.