Accurate eGFR reporting for children without anthropometric data

Emil den Bakker, Reinoud Gemke, Joanna A.E. van Wijk, Isabelle Hubeek, Birgit Stoffel-Wagner, Anders Grubb, Arend Bökenkamp

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. Aim To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data. Methods Retrospective analysis of 408 pediatric inulin clearance studies with simultaneous height, creatinine, cystatin C and urea measurements. eGFR calculation using the recalibrated Schwartzcrea (height-dependent), FASage (height-independent) and the Schwartzcys equation. The means (Schwartzcrea + Schwartzcys) / 2 and (FASage + Schwartzcys) / 2 were compared with the CKiD3 equation incorporating cystatin C, creatinine, urea, height and gender in terms of %prediction error and accuracy. Results All three single parameter equations performed similarly (P30 accuracy around 80%). (FASage + Schwartzcys) / 2 (P30 89.2%) and (Schwartzcrea + Schwartzcys) / 2 (P30 89.0%), performed comparably to CKiD3 (P30 90.0%). If the difference between the creatinine- and the cystatine C based eGFR was < 40%, P30 accuracy of the mean exceeded 90%. Conclusion Combining the height-independent FASage and SchwartzCys equations substantially improves accuracy and performs comparably to height-dependent equations. This allows laboratories to directly report eGFR in children.

Original languageEnglish
Pages (from-to)38-43
Number of pages6
JournalClinica Chimica Acta
Volume474
DOIs
Publication statusPublished - 1 Nov 2017

Cite this

@article{68fb857c8ec642aba18380bb72eccd6e,
title = "Accurate eGFR reporting for children without anthropometric data",
abstract = "Introduction Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. Aim To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data. Methods Retrospective analysis of 408 pediatric inulin clearance studies with simultaneous height, creatinine, cystatin C and urea measurements. eGFR calculation using the recalibrated Schwartzcrea (height-dependent), FASage (height-independent) and the Schwartzcys equation. The means (Schwartzcrea + Schwartzcys) / 2 and (FASage + Schwartzcys) / 2 were compared with the CKiD3 equation incorporating cystatin C, creatinine, urea, height and gender in terms of {\%}prediction error and accuracy. Results All three single parameter equations performed similarly (P30 accuracy around 80{\%}). (FASage + Schwartzcys) / 2 (P30 89.2{\%}) and (Schwartzcrea + Schwartzcys) / 2 (P30 89.0{\%}), performed comparably to CKiD3 (P30 90.0{\%}). If the difference between the creatinine- and the cystatine C based eGFR was < 40{\%}, P30 accuracy of the mean exceeded 90{\%}. Conclusion Combining the height-independent FASage and SchwartzCys equations substantially improves accuracy and performs comparably to height-dependent equations. This allows laboratories to directly report eGFR in children.",
keywords = "Children, Creatinine, Cystatin C, Estimated GFR, Heightindependent",
author = "{den Bakker}, Emil and Reinoud Gemke and {van Wijk}, {Joanna A.E.} and Isabelle Hubeek and Birgit Stoffel-Wagner and Anders Grubb and Arend B{\"o}kenkamp",
year = "2017",
month = "11",
day = "1",
doi = "10.1016/j.cca.2017.09.004",
language = "English",
volume = "474",
pages = "38--43",
journal = "Clinica Chimica Acta",
issn = "0009-8981",
publisher = "Elsevier",

}

Accurate eGFR reporting for children without anthropometric data. / den Bakker, Emil; Gemke, Reinoud; van Wijk, Joanna A.E.; Hubeek, Isabelle; Stoffel-Wagner, Birgit; Grubb, Anders; Bökenkamp, Arend.

In: Clinica Chimica Acta, Vol. 474, 01.11.2017, p. 38-43.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Accurate eGFR reporting for children without anthropometric data

AU - den Bakker, Emil

AU - Gemke, Reinoud

AU - van Wijk, Joanna A.E.

AU - Hubeek, Isabelle

AU - Stoffel-Wagner, Birgit

AU - Grubb, Anders

AU - Bökenkamp, Arend

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Introduction Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. Aim To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data. Methods Retrospective analysis of 408 pediatric inulin clearance studies with simultaneous height, creatinine, cystatin C and urea measurements. eGFR calculation using the recalibrated Schwartzcrea (height-dependent), FASage (height-independent) and the Schwartzcys equation. The means (Schwartzcrea + Schwartzcys) / 2 and (FASage + Schwartzcys) / 2 were compared with the CKiD3 equation incorporating cystatin C, creatinine, urea, height and gender in terms of %prediction error and accuracy. Results All three single parameter equations performed similarly (P30 accuracy around 80%). (FASage + Schwartzcys) / 2 (P30 89.2%) and (Schwartzcrea + Schwartzcys) / 2 (P30 89.0%), performed comparably to CKiD3 (P30 90.0%). If the difference between the creatinine- and the cystatine C based eGFR was < 40%, P30 accuracy of the mean exceeded 90%. Conclusion Combining the height-independent FASage and SchwartzCys equations substantially improves accuracy and performs comparably to height-dependent equations. This allows laboratories to directly report eGFR in children.

AB - Introduction Reporting estimated glomerular filtration rate (eGFR) instead of serum concentrations is advised in current guidelines. Most creatinine-based eGFR equations for children require height, a parameter not readily available to laboratories. Combining height-dependent creatinine- and cystatin C-based eGFR improves performance. Recently, a height-independent creatinine-based eGFR equation has been developed. Aim To compare the combination of height-independent creatinine- and cystatin C-based equations with a combination of equations using anthropometric data. Methods Retrospective analysis of 408 pediatric inulin clearance studies with simultaneous height, creatinine, cystatin C and urea measurements. eGFR calculation using the recalibrated Schwartzcrea (height-dependent), FASage (height-independent) and the Schwartzcys equation. The means (Schwartzcrea + Schwartzcys) / 2 and (FASage + Schwartzcys) / 2 were compared with the CKiD3 equation incorporating cystatin C, creatinine, urea, height and gender in terms of %prediction error and accuracy. Results All three single parameter equations performed similarly (P30 accuracy around 80%). (FASage + Schwartzcys) / 2 (P30 89.2%) and (Schwartzcrea + Schwartzcys) / 2 (P30 89.0%), performed comparably to CKiD3 (P30 90.0%). If the difference between the creatinine- and the cystatine C based eGFR was < 40%, P30 accuracy of the mean exceeded 90%. Conclusion Combining the height-independent FASage and SchwartzCys equations substantially improves accuracy and performs comparably to height-dependent equations. This allows laboratories to directly report eGFR in children.

KW - Children

KW - Creatinine

KW - Cystatin C

KW - Estimated GFR

KW - Heightindependent

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U2 - 10.1016/j.cca.2017.09.004

DO - 10.1016/j.cca.2017.09.004

M3 - Article

VL - 474

SP - 38

EP - 43

JO - Clinica Chimica Acta

JF - Clinica Chimica Acta

SN - 0009-8981

ER -