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New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance

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Abstract

Background

This study compares glomerular filtration rate (GFR) equations in children based on standardized cystatin C (CYSC) and creatinine (CREA) and their combinations with renal clearance of inulin (C-inulin).

Methods

A total of 220 children with different renal disorders were referred for C-inulin (median 84 ml/min/1.73 m2). Bias, precision (interquartile range, IQR), and accuracy (percentage of estimates ±30 % of C-inulin; P30) were evaluated for two cystatin C equations, CAPACYSC and BergCYSC, for creatinine equations, SchwartzCREA and GaoCREA, the arithmetic mean of CAPACYSC and SchwartzCREA (MEANCAPA+Schwartz), BergCYSC and SchwartzCREA (MEANBERG+SCHWARTZ) and the composite equation ChehadeCYSC+CREA.

Results

Overall results of CAPACYSC, BergCYSC, SchwartzCREA, GaoCREA, MEANCAPA+Schwartz, MEANBERG+SCHWARTZ and ChehadeCYSC+CREA were: median bias –7.6/–4.9/–3.7/–2.3/–4.6/–4.0/–10.1 %, IQR 20.0/19.9/21.7/22.4/21.0/20.9/23.3 ml/min/1.73 m2 and P30 86/86/80/83/89/91/83 %. The cystatin C equations, MEANCAPA+Schwartz and MEANBERG+SCHWARTZ had a more stable performance across subgroups compared with SchwartzCREA, GaoCREA and ChehadeCYSC+CREA.

Conclusions

Cystatin C was the preferred filtration marker for GFR estimation in children, while the benefit of combining cystatin C and creatinine deserves further investigations.

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Correspondence to Ulla B. Berg.

Additional information

Rune Bäck has passed away during the study.

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Berg, U.B., Nyman, U., Bäck, R. et al. New standardized cystatin C and creatinine GFR equations in children validated with inulin clearance. Pediatr Nephrol 30, 1317–1326 (2015). https://doi.org/10.1007/s00467-015-3060-3

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  • DOI: https://doi.org/10.1007/s00467-015-3060-3

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