Performance of glomerular filtration rate equations using serum creatinine in children with congenital anomalies of the kidney and urinary tract
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View abstract on PubMed
Summary
This summary is machine-generated.Accurate glomerular filtration rate (GFR) estimation is vital for pediatric chronic kidney disease management. The European Kidney Function Consortium (EKFC) equation showed higher accuracy than bedside Schwartz and CKiD-U25 in children with congenital anomalies of the kidney and urinary tract (CAKUT).
Area Of Science
- Pediatric Nephrology
- Renal Function Assessment
- Biomarker Validation
Background
- Congenital anomalies of the kidney and urinary tract (CAKUT) are a leading cause of pediatric chronic kidney disease (CKD).
- Accurate glomerular filtration rate (GFR) assessment is critical for managing pediatric CKD, yet a gold-standard estimation formula is lacking.
- This study addresses the need for reliable GFR estimation in children with CAKUT.
Purpose Of The Study
- To compare the performance of bedside Schwartz, Chronic Kidney Disease in Children (CKiD-U25), and European Kidney Function Consortium (EKFC) creatinine-based equations against measured GFR (mGFR) in pediatric CAKUT patients.
- To evaluate the accuracy and bias of different GFR estimation formulas in this specific population.
- To identify the most reliable GFR estimation tool for children with CAKUT.
Main Methods
- A cohort of 276 children with CAKUT was studied.
- Estimated GFR (eGFR) was calculated using bedside Schwartz, CKiD-U25, and EKFC equations.
- Measured GFR (mGFR) was determined using technetium-99m-diethylenetriaminepentaacetic acid (Tc-99mDTPA) clearance, considered the gold standard.
Main Results
- All tested equations showed significant correlation with mGFR (Spearman's r ranging from 0.745 to 0.793).
- The bedside Schwartz equation systematically underestimated mGFR (bias: -21.7 mL/min/1.73 m²), while the EKFC equation overestimated it (bias: 17 mL/min/1.73 m²).
- In children over two years, the EKFC equation demonstrated superior accuracy (P30: 90.1%) compared to bedside Schwartz (75%) and CKiD-U25 (75%).
Conclusions
- The bedside Schwartz and EKFC equations can serve as reliable tools for GFR estimation in pediatric CAKUT patients.
- The EKFC equation appears to be a more accurate GFR estimation tool for children over two years with CAKUT.
- Further validation of GFR estimation formulas is essential for optimal pediatric nephrology care.
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