Evaluation of serum creatinine concentration-based glomerular filtration rate equations in pediatric patients with chronic kidney disease.

Abstract

STUDY OBJECTIVE:

To evaluate the accuracy of four equations based on serum creatinine concentration-the original Schwartz equation and the Leger, Bedside Chronic Kidney Disease in Children (CKiD), and Counahan-Barratt equations-for determining glomerular filtration rate (GFR) in pediatric patients with chronic kidney disease.

DESIGN:

Retrospective, observational, cross-sectional study.

SETTING:

Single-center, academic, outpatient pediatric nephrology clinic.

PATIENTS:

Fifty-three pediatric patients with stages 2-5 chronic kidney disease who completed GFR assessment with (125) I-iothalamate between January 2002 and January 2005.

MEASUREMENT AND MAIN RESULTS:

Data were collected from each patient's medical record. Glomerular filtration rate data were analyzed using 59 evaluations from the 53 pediatric patients. (125) I-iothalamate clearance was used as the index GFR. The Bedside CKiD and Counahan-Barratt equations outperformed the Schwartz and Leger equations when the index GFR was less than 60 ml/minute/1.73 m(2) ; the Schwartz and Counahan-Barratt equations performed best for index GFRs of 60 ml/minute/1.73 m(2) or greater. Overestimation was highest with the Schwartz and Leger equations (> 20% index GFR in 57.6% and 62.7% of patients, respectively). Underestimation was highest with the Bedside CKiD and Counahan-Barratt equations (> 20% index GFR in 30.5% and 28.8%, respectively).

CONCLUSION:

The new Bedside CKiD equation performed well for pediatric patients with moderate-to-severe chronic kidney disease, but less well for pediatric patients with mild disease. Additional studies are needed to develop more precise GFR equations using serum creatinine concentration.

• Authors: Carlton K K Lee, Rita D Swinford, Ruby D Cerda, Ronald J Portman, Wenke Hwang, Susan L Furth
• Journal: Pharmacotherapy (Pharmacotherapy) Vol. 32 Issue 7 Pg. 642-8 (Jul 2012) ISSN: 1875-9114 [Electronic] United States
• PMID: 22623290 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2012 Pharmacotherapy Publications, Inc. All rights reserved.

Chemical References

• Creatinine

Topics

• Adolescent
• Child
• Child, Preschool
• Chronic Disease
• Creatinine (blood)
• Cross-Sectional Studies
• Female
• Glomerular Filtration Rate
• Humans
• Kidney Diseases (diagnosis, physiopathology)
• Kidney Function Tests (methods)
• Male
• Retrospective Studies
• Severity of Illness Index
• Young Adult