Evaluation of height-dependent and height-independent methods of estimating baseline serum creatinine in critically ill children

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Erin HesseyMichael Zappitelli

Abstract

Baseline serum creatinine (bSCr) is required for diagnosing acute kidney injury (AKI). In children, bSCr is commonly defined as the lowest measurement within 3 months of admission. Measured values are often missing and estimating bSCr using height-based glomerular filtration rate (GFR) equations is problematic when height is unavailable. This is a retrospective cohort study including 538 children admitted to the intensive care unit (ICU) between 2003 and 2005 at two centers in Canada, with measured bSCr, height, and ICU-SCr values. We evaluated the bias, accuracy, and precision of back-calculating bSCr from height-dependent and height-independent GFR equations. Agreement of AKI defined using measured and estimated bSCr was calculated. Multivariate analyses were performed to assess the impact of bSCr estimation methods on the association between AKI and ICU mortality, length of stay, and duration of mechanical ventilation. Both methods underestimated bSCr by 1-3%, showed good accuracy (∼30% of patients with estimated bSCr within 10% of measured bSCr), but poor precision (wide 95% limits of agreement). The agreement between AKI defined by estimated versus measured bSCr was >80% (κ >0.5). The height-independent method performed be...Continue Reading

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Citations

May 2, 2018·Hospital Pediatrics·Erin HesseyMichael Zappitelli
Apr 22, 2018·Clinical Journal of the American Society of Nephrology : CJASN·Erin HesseyMichael Zappitelli
Sep 20, 2019·Pediatric Research·Erika R O'NeilAndrea T Cruz
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Oct 31, 2019·Canadian Journal of Kidney Health and Disease·Erin HesseyMichael Zappitelli
Mar 13, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Erin HesseyMichael Zappitelli
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