ESPN 51th Annual Meeting

ESPN 2018


 
Which eGFR equation should be used in children to determinate CKD?
SEÇIL CONKAR 1 SEVGI MİR 1

1- EGE UNIVERSITY FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRIC NEPHROLOGY
 
Introduction:

Glomerular Filtration Rate (GFR) is the best indicator of kidney function. The Kidney Disease Outcomes Quality Initiative (KDOQI) 2000 guidelines of the National Kidney Foundation suggest the use of the Schwartz formula or the serum Scr-based eGFR equations for children in the assessment of chronic kidney disease (CKD). We assessed correlations between eGFR equations based on Scr, CysC, CysC-Scr, and creatinine clearance (CrCl24).

Material and methods:

In our study, we calculated eGFR values according to five measurement methods: 1) the original Schwartz formula, 2) creatinine clearance 3) CKiD-eGFR-cysC 4) CKiD-eGFR-creat-cysC, and 5) Bedside Schwartz. Using the creatinine clearance as a gold standard, we calculated the specificity and sensitivity of all eGFR equations in determining GFR <90ml/min/1.73m2. CysC was measured by the Particle Enhanced Nephelometric Immunoassay (PENIA) method.

 

Results:

A total of 238 children were enrolled from the Ege University pediatric nephrology clinic. Of the cases, 117 (49.2%) were males and 121 (50.8%) were females. The mean age was 9.91 ± 5.7 years. When the GFR cut-off was taken as 90 ml/min/1.73m2 using creatinine clearance, the area under the curve analyzed by Receiver Operating Curve (ROC)c for CKiD-eGFR-cysC, Counter-Barratt, CKiD-eGFR-creat-cysC, Bedside Schwartz, and Original Schwartz was found 0.89, 0.88, 0.89, 0.88, and 0.86 respectively. The CKiD-eGFR-cysC and CKiD-eGFR-creat-cysC were identified as the most sensitive formula for determining GFR<90 ml/min/1.73m2

Conclusions:

Bedside Schwartz is ideally suited for the daily practice because it uses the same constant “k” for all age groups. Also, the Original Schwartz can be used to determine normal renal function. In this study, we found that CKiD-eGFR-Scr-CysC is the most ideal and reliable eGFR equation to determinate GFR <90 min / 1.73m2.