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Schwartz, G.J. et al.

George J. Schwartz, Michael F. Schneider, Paula S. Maier, Marva Moxey-Mims, Vikas R. Dharnidharka, Bradley A. Warady, Susan L. Furth, Alvaro Muñoz, Michael F. Schneider, Paula S. Maier, Marva Moxey-Mims, Vikas R. Dharnidharka, Bradley A. Warady, Susan L. Furth, Alvaro Muñoz,

Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C.

The Chronic Kidney Disease in Children study is a cohort of about 600 children with chronic kidney disease (CKD) in the United States and Canada. The independent variable for our observations was a measurement of glomerular filtration rate(GFR) by iohexol disappearance (iGFR) at the first two visits 1 year apart and during alternate years thereafter. In a previous report, we had developed GFR estimating equations utilizing serum creatinine, blood urea nitrogen, height, gender, and cystatin C measured by an immunoturbidimetric method; however, the correlation coefficient of cystatin C and GFR(0.69) was less robust than expected. Therefore, 495 samples were re-assayed using immunonephelometry. The reciprocal of immunonephelometric cystatin C was as well correlated with iGFR as was height/serum creatinine (both 0.88). We developed a new GFR estimating equation using a random 2/3 of 965 person-visits and applied it to the remaining 1/3 as a validation data set. In the validation dataset, the correlation of the estimated GFR with iGFR was 0.92 with high precision and no bias; 91 and 45% of eGFR values were within 30 and 10% of iGFR, respectively. This equation works well in children with CKD in a range of GFR from 15 to 75 ml/min per 1.73 m2. Further studies are needed to establish the applicability to children of normal stature and muscle mass, and higher GFR.[1]

References

Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C. Schwartz, G.J., Schneider, M.F., Maier, P.S., Moxey-Mims, M., Dharnidharka, V.R., Warady, B.A., Furth, S.L., Muñoz, A. Kidney Int. (2012) [Pubmed]

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