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Estimation of the glomerular filtration rate in children: which algorithm should be used?

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Abstract

Glomerular filtration rate (GFR) in children can be estimated by the formula GFR=k×BH/Pcr (where BH is body height in centimetres and Pcr is the plasma creatinine concentration in micromoles per litre). For k, several values have been reported: k=38 (Counahan), k=40 (Morris) and k=48.7 (Schwartz). In this study the predictive performance of these formulae was compared with that of newly developed formulae. GFR measurements based on inulin concentration time curves were divided into an index (n=58) and a validation data set (n=48). In the index data set a value for k was derived by application of nonlinear mixed-effect modelling. This approach was also used to develop a formula that better explained the relationship between patient factors and GFR. Bias and precision of all formulae were calculated for the validation data set. In the index data set a value of 41.2 was found for k, which was close to the value k=40 (Morris). Both formulae estimated GFR well (bias <5%; precision 25%). Further modelling of the relationship between patient factors and GFR did not improve the predictive performance. In our hospital GFR was best estimated by the formula with k=40 and k=41.2. It is recommended that the optimal value for k be assessed locally.

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Acknowledgements

We would like to thank Prof. Dr. J. Lindemans and Dr. Y.B. de Rijke, Department of Clinical Chemistry, Erasmus MC, Rotterdam, for their scientific support.

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Authors and Affiliations

  1. Department of Hospital Pharmacy, Erasmus MC, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands

    Lyonne K. van Rossum, Ron A. A. Mathot & Arnold G. Vulto

  2. Department of Paediatric Nephrology, Erasmus MC-Sophia, Rotterdam, The Netherlands

    Karlien Cransberg

  3. Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands

    Robert Zietse

Authors
  1. Lyonne K. van Rossum
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  2. Ron A. A. Mathot
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  3. Karlien Cransberg
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  4. Robert Zietse
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  5. Arnold G. Vulto
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Correspondence to Lyonne K. van Rossum.

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van Rossum, L.K., Mathot, R.A.A., Cransberg, K. et al. Estimation of the glomerular filtration rate in children: which algorithm should be used?. Pediatr Nephrol 20, 1769–1775 (2005). https://doi.org/10.1007/s00467-005-2001-y

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  • DOI: https://doi.org/10.1007/s00467-005-2001-y

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