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Comparative Study
. 2012 Jul;32(7):642-8.
doi: 10.1002/j.1875-9114.2012.01095.x. Epub 2012 May 24.

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

Carlton K K Lee  1 , Rita D Swinford, Ruby D Cerda, Ronald J Portman, Wenke Hwang, Susan L Furth
Affiliations
Comparative Study

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

Carlton K K Lee et al. Pharmacotherapy. 2012 Jul.

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.

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Figures

Figure 1
Figure 1
Comparison of estimated glomerular filtration rate (GFR) using four equations with actual GFR determined by 125I-iothalamate (Glofil-125) clearance. CKiD = Chronic Kidney Disease in Children.
Figure 2
Figure 2
Bland-Altman plots for each glomerular filtration rate (GFR) estimation method versus actual GFR determined by 125I-iothalamate (Glofil-125) clearance. CKiD = Chronic Kidney Disease in Children.
See this image and copyright information in PMC

References

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