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Measuring glomerular filtration rate in children; can cystatin C replace established methods? A review

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Abstract

Our aim was to evaluate published methods that use serum cystatin C (s-CysC) for measuring glomerular filtration rate (GFR) in children and to discuss advantages and limitations of s-CysC and of established GFR methods. A comprehensive literature review of clinical studies in children evaluating s-CysC or CysC-based formulas and plasma creatinine or creatinine-based formulas against an exogenous reference method using receiver operating characteristics (ROC) curves or Bland–Altman plots is presented. The comparison of s-CysC with plasma creatinine indicated that s-CysC was superior to plasma creatinine in five of 13 studies; four studies showed no difference, and, in four studies, no statistical comparison was made. Comparison of s-CysC and the Schwartz formula showed that s-CysC was superior to the Schwartz formula in two of seven studies; two studies demonstrated no difference, and, in one study, the Schwartz formula was superior to s-CysC. In two studies no statistical comparison was made. The CysC-based prediction equations all had high accuracy but low agreement when compared with a reference GFR, in the range of 30–40% at best. S-CysC is most likely superior to plasma creatinine and at least equal to creatinine-based formulas. CysC-based prediction equations are at least as good as creatinine-based formulas but cannot replace exogenous methods.

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Acknowledgments

Support for this study was provided by Aarhus University Hospital, The John and Birthe Meyer Foundation, The Aase and Ejnar Danielsen Foundation, The Heinrich Kopps Foundation, The Danish National Research Council and The University of Aarhus.

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  1. Department of Clinical Physiology and Nuclear Medicine, Aarhus University Hospital, Aalborg Sygehus, Hobrovej 18–22, 9000, Aalborg, Denmark

    Trine Borup Andersen, Anni Eskild-Jensen, Jørgen Frøkiær & Jens Brøchner-Mortensen

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  1. Trine Borup Andersen
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  2. Anni Eskild-Jensen
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  3. Jørgen Frøkiær
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  4. Jens Brøchner-Mortensen
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Correspondence to Trine Borup Andersen.

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Andersen, T.B., Eskild-Jensen, A., Frøkiær, J. et al. Measuring glomerular filtration rate in children; can cystatin C replace established methods? A review. Pediatr Nephrol 24, 929–941 (2009). https://doi.org/10.1007/s00467-008-0991-y

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  • DOI: https://doi.org/10.1007/s00467-008-0991-y

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