Estimated glomerular filtration rates cannot replace measured GFR in type 1 diabetes patients with hyperfiltration

Acta Paediatrica
Nes Perrin, U B Berg

Abstract

This study of children and young adults with type 1 diabetes with normal to high glomerular filtration rates (GFR) compared estimated GFR (eGFR) with measured GFR (mGFR). GFR was measured by inulin clearance, and we carried out simultaneous analyses of standardised creatinine and cystatin C. eGFR was calculated using different formulas. We enrolled 106 patients, including 56 males, aged 21.9 (standard deviation 9.2) years with 13.7 (9.1) years' duration of diabetes and a mean haemoglobin A1c (HbA1c ) of 7.7% (61 mmol/mol). The median mGFR was 128 (111-143) mL/min/1.73 m(2) . Most of the eGFR estimations failed to detect a significant proportion of hyperfiltration based on inulin clearance. The best accuracy (P30) between eGFR and mGFR was seen with eGFRCKD - EPI (92%), eGFRcys C Berg (86%), eGFRcys C CAPA (78%) and eGFRcys C Inker (84%) where eGFRCKD - EPI and eGFR cys C Berg showed the lowest bias. Most eGFRcys C measurements showed greater accuracy when combined with eGFRcr (P30 92-94%). The best accuracy (P30) and lowest bias were found with eGFRCKD - EPI and eGFR Berg. in this cohort. However, eGFR cannot accurately replace mGFR to detect hyperfiltration and follow GFR over time in young patients with type 1 diabetes.

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Citations

Jan 25, 2016·Current Diabetes Reports·Petter BjornstadKristen J Nadeau
Nov 4, 2015·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Jin-Soon SuhByoung Kyu Suh
Sep 21, 2016·PLoS Medicine·Giuseppe Remuzzi, Richard Glassock
Dec 15, 2017·Journal of Pediatric Gastroenterology and Nutrition·Ulla B Berg, Antal Németh
Feb 2, 2018·Critical Reviews in Clinical Laboratory Sciences·Emil den BakkerArend Bökenkamp
Jun 15, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Petter Bjornstad, David Z I Cherney
Nov 23, 2019·Scandinavian Journal of Clinical and Laboratory Investigation·Emil den BakkerArend Bökenkamp

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