Validation of standardized creatinine and cystatin C GFR estimating equations in a large multicentre European cohort of children

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Validation of standardized creatinine and cystatin C GFR estimating equations in a large multicentre European cohort of children

Björk, Jonas (author): Lund University,Lunds universitet,Avdelningen för arbets- och miljömedicin,Institutionen för laboratoriemedicin,Medicinska fakulteten,Division of Occupational and Environmental Medicine, Lund University,Department of Laboratory Medicine,Faculty of Medicine,Skåne University Hospital

Nyman, Ulf (author): Lund University,Lunds universitet,Diagnostisk radiologi, Malmö,Forskargrupper vid Lunds universitet,Radiology Diagnostics, Malmö,Lund University Research Groups

Berg, Ulla (author): Karolinska Institutet,Karolinska Institute,Karolinska University Hospital

Delanaye, Pierre (author): University of Liège

Dubourg, Laurence (author): Hôpital Edouard Herriot,Claude Bernard University Lyon 1

Goffin, Karolien (author): University Hospitals Leuven

Grubb, Anders (author): Lund University,Lunds universitet,Cystatin C, njursjukdom, amyloidos och antibiotika,Forskargrupper vid Lunds universitet,Cystatin C, renal disease, amyloidosis and antibiotics,Lund University Research Groups,Skåne University Hospital

Hansson, Magnus (author): Karolinska Institutet,Karolinska Institute,Karolinska University Hospital

Littmann, Karin (author): Karolinska Institutet,Karolinska Institute,Karolinska University Hospital

Åsling-Monemi, Kajsa (author): Karolinska Institutet,Karolinska Institute,Karolinska University Hospital

Bökenkamp, Arend (author): Vrije Universiteit Amsterdam,Emma Children’s Hospital

Pottel, Hans (author): Catholic University of Leuven

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2019-02-04
2019
English.
In: Pediatric Nephrology. - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X.

Related links:: http://dx.doi.org/10...; show more...; https://orbi.uliege....; https://lup.lub.lu.s...; https://doi.org/10.1...; http://kipublication...; show less...

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Background: Most validations of paediatric glomerular filtration rate (GFR) estimating equations using standardized creatinine (CR) and cystatin C (CYS) assays have comprised relatively small cohorts, which makes accuracy across subgroups of GFR, age, body mass index (BMI) and gender uncertain. To overcome this, a large cohort of children referred for GFR determination has been established from several European medical centres. Methods: Three thousand four hundred eight measurements of GFR (mGFR) using plasma clearance of exogenous substances were performed in 2218 children aged 2–17 years. Validated equations included Schwartz-2009CR/2012CR/CYS/CR+CYS, FASCR/CYS/CR+CYS, LMRCR, Schwartz-LyonCR, BergCYS, CAPACYS, CKD-EPICYS, AndersenCR+CYS and arithmetic means of the best single-marker equations in explorative analysis. Five metrics were used to compare the performance of the GFR equations: bias, precision and three accuracy measures including the percentage of GFR estimates (eGFR) within ± 10% (P10) and ± 30% (P30) of mGFR. Results: Three of the cystatin C equations, BergCYS, CAPACYS and CKD-EPICYS, exhibited low bias and generally satisfactory accuracy across all levels of mGFR; CKD-EPICYS had more stable performance across gender than the two other equations. Among creatinine equations, Schwartz-LyonCR had the best performance but was inaccurate at mGFR < 30 mL/min/1.73 m2 and in underweight patients. Arithmetic means of the best creatinine and cystatin C equations above improved bias compared to the existing composite creatinine+cystatin C equations. Conclusions: The present study strongly suggests that cystatin C should be the primary biomarker of choice when estimating GFR in children with decreased GFR. Arithmetic means of well-performing single-marker equations improve accuracy further at most mGFR levels and have practical advantages compared to composite equations.

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By the author/editor: Björk, Jonas; Nyman, Ulf; Berg, Ulla; Delanaye, Pierre; Dubourg, Laurenc ...; Goffin, Karolien; show more...; Grubb, Anders; Hansson, Magnus; Littmann, Karin; Åsling-Monemi, K ...; Bökenkamp, Arend; Pottel, Hans; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Urology and Neph ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

Articles in the publication: Pediatric Nephro ...

By the university: Lund University; Karolinska Institutet

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Validation of standardized creatinine and cystatin C GFR estimating equations in a large multicentre European cohort of children

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