Estimating glomerular filtration rate (GFR) in children. The average between a cystatin C- and a creatinine-based equation improves estimation of GFR in both children and adults and enables diagnosing Shrunken Pore Syndrome

Scandinavian Journal of Clinical and Laboratory Investigation
Felicia LeionAnders Grubb

Abstract

Estimating glomerular filtration rate (GFR) in adults by using the average of values obtained by a cystatin C- (eGFRcystatin C) and a creatinine-based (eGFRcreatinine) equation shows at least the same diagnostic performance as GFR estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparison of eGFRcystatin C and eGFRcreatinine plays a pivotal role in the diagnosis of Shrunken Pore Syndrome, where low eGFRcystatin C compared to eGFRcreatinine has been associated with higher mortality in adults. The present study was undertaken to elucidate if this concept can also be applied in children. Using iohexol and inulin clearance as gold standard in 702 children, we studied the diagnostic performance of 10 creatinine-based, 5 cystatin C-based and 3 combined cystatin C-creatinine eGFR equations and compared them to the result of the average of 9 pairs of a eGFRcystatin C and a eGFRcreatinine estimate. While creatinine-based GFR estimations are unsuitable in children unless calibrated in a pediatric or mixed pediatric-adult population, cystatin C-based estimations in general performed well in children. The average of a suitable creatinine-based and a cystatin C-based equation gen...Continue Reading

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Citations

Feb 2, 2018·Critical Reviews in Clinical Laboratory Sciences·Emil den BakkerArend Bökenkamp
Oct 27, 2017·Scandinavian Journal of Clinical and Laboratory Investigation·Martin RischLorenz Risch
May 19, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Emil den BakkerArend Bökenkamp
Feb 5, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Jonas BjörkHans Pottel
Mar 12, 2019·The Cochrane Database of Systematic Reviews·Esmee Cm KooijmansMargreet A Veening
Feb 21, 2019·Scandinavian Journal of Clinical and Laboratory Investigation·Araceli Jarquin CamposMartin Risch
Nov 23, 2019·Scandinavian Journal of Clinical and Laboratory Investigation·Emil den BakkerArend Bökenkamp
May 28, 2020·Scandinavian Journal of Clinical and Laboratory Investigation·Anna ÅkessonAnders Grubb
Oct 7, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Jonas BjörkUlf Nyman
Sep 2, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Cathrin L SalvadorLars Mørkrid
Aug 10, 2019·Clinica Chimica Acta; International Journal of Clinical Chemistry·Hua ZhouNing Xu
Jan 19, 2021·Scandinavian Journal of Clinical and Laboratory Investigation·Emil den BakkerArend Bokenkamp
Nov 21, 2021·Clinical Pharmacology and Therapeutics·Ashish SharmaJitendra Kanodia

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