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Endogenous markers for kidney function in children: a review.

Emil den Bakker1, Reinoud J B J Gemke1, Arend Bökenkamp1

  • 1a Department of Pediatric Nephrology , VU Medical Centre , Amsterdam , The Netherlands.

Critical Reviews in Clinical Laboratory Sciences
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Estimating glomerular filtration rate (GFR) in children is crucial. This review covers endogenous markers like creatinine and cystatin C, and equations for estimated GFR (eGFR) in pediatric populations.

Keywords:
Cystatin Cbeta-2 microglobulinbeta-trace proteinclearance studycreatinineestimated GFRphysiologyurea

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Area of Science:

  • Pediatric Nephrology
  • Biomarkers of Kidney Function

Background:

  • Glomerular filtration rate (GFR) is a key indicator of kidney function in children.
  • Gold-standard GFR measurement is invasive and not widely accessible.
  • Estimated GFR (eGFR) using endogenous markers is a common alternative.

Purpose of the Study:

  • To review endogenous markers for kidney function in children.
  • To discuss the development and application of eGFR equations in pediatrics.
  • To provide an overview of current pediatric eGFR equations.

Main Methods:

  • Review of established endogenous markers: creatinine, urea, cystatin C, beta-trace protein, beta-2 microglobulin.
  • Discussion of marker physiology, measurement, and standardization.
  • Analysis of eGFR equation development and performance in children.

Main Results:

  • Multiple endogenous markers exist, each with unique characteristics.
  • Standardization of creatinine and cystatin C measurements has improved accuracy.
  • Multi-marker eGFR equations generally outperform single-marker equations in children.

Conclusions:

  • Endogenous markers and eGFR equations are vital for assessing pediatric kidney function.
  • Understanding marker properties and equation methodologies is essential for accurate eGFR.
  • This review provides a comprehensive guide to pediatric eGFR assessment.