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Estimating creatinine clearance in children: comparison of three methods
American Journal of Hospital Pharmacy
|November 1, 1980
Summary
The Schwartz et al. method (Method I) is the most accurate and simple way to estimate creatinine clearance in children. This method, based on height and serum creatinine, is superior to Shull et al. and Rudd et al. methods.
Area of Science:
- Pediatric Nephrology
- Clinical Chemistry
Background:
- Estimating creatinine clearance (Clcr) is crucial for assessing kidney function in children.
- Accurate Clcr estimation aids in medication dosing and monitoring renal health.
Purpose of the Study:
- To compare the accuracy and clinical utility of three common methods for estimating creatinine clearance in pediatric patients.
- To identify the most reliable method for routine use in pediatric care.
Main Methods:
- Compared measured Clcr with estimated Clcr values from Schwartz et al. (Method I), Shull et al. (Method II), and Rudd et al. (Method III) in 58 pediatric patients (ages 1-16).
- Calculated mean prediction error and correlation coefficients (r) for each method against measured Clcr.
- Normalized all Clcr values to ml/min/1.73 sq m of body surface area.
Main Results:
- All three methods showed good correlation with measured Clcr (r = 0.90 for Method I, 0.85 for Method II, 0.80 for Method III; p < 0.0001).
- Method I (Schwartz et al.) and Method III (Rudd et al.) demonstrated significantly higher accuracy with smaller mean prediction errors (-2.8 to 4.1 ml/min/1.73 sq m) compared to Method II (-17.4 ml/min/1.73 sq m).
- Method I was identified as the most accurate, simplest, and clinically useful estimation method.
Conclusions:
- The Schwartz et al. method (Method I) is recommended for estimating creatinine clearance in pediatric patients due to its superior accuracy and simplicity.
- Further studies are needed to determine the applicability of these methods in pediatric patients with severe renal disease.