Skip to main content
Log in

Applicability of various estimation formulas to assess renal function in Chinese children

  • Original article
  • Published:
World Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Background

This study was to evaluate the relative applicability of the most commonly used estimation formulas for renal glomerular filtration rate (GFR) of Chinese children with chronic kidney disease (CKD).

Methods

One hundred CKD patients of less than 17 years old were divided into two groups by sex which was further categorized into five subgroups based on CKD staging according to the "reference" GFR (rGFR) determined by Tc-99m-DTPA renal dynamic imaging. Four GFR markers including serum cystatin C (CysC), β2-microglobulin, creatinine, and blood urea nitrogen were measured.

Results

Among all four markers, CysC best reflected the extent of glomerular damages for CKD stage 1. The value for estimation of GFR (eGFR) was derived from five different formulas either over-estimated or underestimated GFR as referenced to rGFR, and the extent of deviations was dependent on gender, age and CKD stage. The Counahan-Barratt formula and the Schwartz formula gave the most accurate estimations of GFR for CKD stages 1 and 2-3, respectively regardless of gender and age differences. Receiver operating characteristic analyses indicated that the Counahan-Barratt formula has the highest diagnostic accuracy.

Conclusion

The Counahan-Barratt formula provides the best approximation to rGFR, thereby the highest applicability to Chinese children with CKD of different genders, ages and CKD stages.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Delanaye P, Ebert N. Assessment of kidney function: Estimating GFR in children. Nat Rev Nephrol 2012;8:503–504.

    Article  CAS  PubMed  Google Scholar 

  2. Schwartz GJ, Work DF. Measurement and estimation of GFR in children and adolescents. Clin J Am Soc Nephrol 2009;4:1832–1843.

    Article  PubMed  Google Scholar 

  3. Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20:629–637.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Grubb AO. Cystatin C-properties and use as diagnostic marker. Adv Clin Chem 2000;35:63–99.

    Article  CAS  PubMed  Google Scholar 

  5. Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular fi ltration rate in infants children and adolescents. Pediatr Clin North Am 1987;34:571–590.

    CAS  PubMed  Google Scholar 

  6. Grootendorst DC, Michels WM, Richardson JD, Jager KJ, Boeschoten EW, Dekker FW, et al. The MDRD formula dose not reflect GFR in ESRD patients. Nephrol Dial Transplant 2011;26:1932–1937.

    Article  PubMed  Google Scholar 

  7. Qutb A, Syed G, Tamim HM, Al Jondeby M, Jaradat M, Tamimi W, et al. Cystain C-based formula is superior to MDRD, Cockcroft-Gault and Nankivell formulae in estimating the glomerular fi ltration rate in renal allografts. Exp Clin Transplant 2009;7:197–202.

    PubMed  Google Scholar 

  8. Lee CK, Swinford RD, Cerda RD, Portman RJ, Hwang W, Furth SL. Evaluation of serum creatinine concentration-based glomerular filtration rate equations in pediatric patients with chronic kidney disease. Pharmacotherapy 2012;32:642–648.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Bevc S, Hojs R, Ekart R, Gorenjak M, Puklavec L. Simple cystatin C formula compared to sophisticated CKD-EPI formulas for estimation of glomerular filtration rate in the elderly. Ther Apher Dial 2011;15:261–268.

    Article  PubMed  Google Scholar 

  10. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classifi cation and stratifi cation. Am J Kidney Dis 2002;39(Suppl 1):S1–246.

    Article  Google Scholar 

  11. Blaufox MD, Aurell M, Bubeck B, Fommei E, Piepsz A, Russell C, et al. Report of the radionuclides in nephrourology committee on renal clearance. J Nucl Med 1996;37:1883–1890.

    CAS  PubMed  Google Scholar 

  12. Vivier PH, Storey P, Rusinek H, Zhang JL, Yamamoto A, Tantillo K, et al. Kidney function: glomerular fi ltration rate measurement with MR renography in patients with cirrhosis. Radiology 2011;259:462–470.

    Article  PubMed  Google Scholar 

  13. Prigent A, Cosgriff P, Gates GF, Granerus G, Fine EJ, Itoh K, et al. Consensus report on quality control of quantitative measurements of renal function obtained from the renogram: International Consensus Committee from the Scientific Committee of Radionuclides in Nephrourology. Semin Nucl Med 1999;29:146–159.

    Article  CAS  PubMed  Google Scholar 

  14. Filler G, Foster J, Acker A, Lepage N, Akbari A, Ehrich JH. The Cockcroft-Gault formula should not be used in children. Kidney Int 2005;67:2321–2324.

    Article  PubMed  Google Scholar 

  15. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers NL, Roth D. A more accurate method to estimate glomerular fi ltration rate from serum creatinine: a new prediction equation. Ann Intern Med 1999;130:461–470.

    Article  CAS  PubMed  Google Scholar 

  16. Counahan R, Chantler C, Ghazali S, Kirkwood B, Rose F, Barratt TM. Estimation of glomerular filtration rate from plasma creatinine concentration in children. Arch Intern Med 1976;51:875–878.

    CAS  Google Scholar 

  17. Abraham BP, Frazier EA, Morrow WR, Blaszak RT, Devarajan P, Mitsnefes M, et al. Cystatin C and neutrophil gelatinaseassociated lipocalin as markers of renal function in pediatric heart transplant recipients. Pediatr Transplant 2011;15:564–569.

    CAS  PubMed  Google Scholar 

  18. Bacchetta J, Cochat P, Rognant N, Ranchin B, Hadj-Aissa A, Dubourg L. Which creatinine and cystatin C equations can be reliably used in children? Clin J Am Soc Nephrol 2011;6:552–560.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Vupputuri S, Fox CS, Coresh J, Woodward M, Muntner P. Differential estimation of CKD using creatinine-versus cystatin C–based estimating equations by category of body mass index. Am J Kidney Dis 2009;53:993–1001.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Blufpand HN, Tromp J, Abbink FC, Stoffel-Wagner B, Bouman AA, Schouten-van Meeteren AY, et al. Cystatin C more accurately detects mildly impaired renal function than creatinine in children receiving treatment for malignancy. Pediatr Blood Cancer 2011;57:262–267. [In Chinese]

    Article  PubMed  Google Scholar 

  21. Ruan YY, Feng JT, Huang ZQ, Qin WL, Mou JF. Diagnostic value of serum cystatin C in renal function impairments in children with viral encephalitis. Zhongguo Dang Dai Er Ke Za Zhi 2011;13:119–122.

    CAS  PubMed  Google Scholar 

  22. Herrero-Morín JD, Málaga S, Fernández N, Rey C, Diéguez MA, Solís G, et al. Cystatin C and beta2-microglobulin:markers of glomerular filtration in critically ill children. Crit Care 2007;11:R59.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Filler G, Priem F, Lepage N, Sinha P, Vollmer I, Clark H, et al. ß-Trace Protein, cystatin C, ß2-microglobulin, and creatinine compared for detecting impaired glomerular filtration rates in children. Clin Chem 2002;48:729–736.

    CAS  PubMed  Google Scholar 

  24. Donadio C, Lucchesi A, Ardini M, Donadio E, Giordani R. Serum levels of beta-trace protein and glomerular fi ltration rate-preliminary results. J Pharm Biomed Anal 2003;32:1099–1104.

    Article  CAS  PubMed  Google Scholar 

  25. Zappitelli M, Joseph L, Gupta IR, Bell L, Paradis G. Validation of child serum creatinine-based prediction equations for glomerular fi ltration rate. Pediatr Nephrol 2007;22:272–281.

    Article  PubMed  Google Scholar 

  26. Bacchetta J, Cochat P, Rognant N, Ranchin B, Hadj-Aissa A, Dubourg L. Which creatinine and cystatin C equations can be reliably used in children? Clin J Am Soc Nephrol 2011;6:552–560.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Selistre L, De Souza V, Cochat P, Antonello IC, Hadj-Aissa A, Ranchin B, et al. GFR estimation in adolescents and young adults. J Am Soc Nephrol 2012;23:989–996.

    Article  CAS  PubMed  Google Scholar 

  28. De Souza VC, Rabilloud M, Cochat P, Selistre L, Hadj-Aissa A, Kassai B, et al. Schwartz formula: is one k-coeffi cient adequate for all children? PLoS One 2012;7:e53439.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Xie P, Huang JM, Liu XM, Wu WJ, Pan LP, Lin HY. (99m)Tc-DTPA renal dynamic imaging method may be unsuitable to be used as the reference method in investigating the validity of CDK-EPI equation for determining glomerular filtration rate. PLoS One 2013;8:e62328.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yue Du.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Du, Y., Sun, TT., Hou, L. et al. Applicability of various estimation formulas to assess renal function in Chinese children. World J Pediatr 11, 346–351 (2015). https://doi.org/10.1007/s12519-014-0532-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-014-0532-7

Keywords

Navigation