Abstract
Pediatric formulae to estimate glomerular filtration rate (eGFR) give a broad range of values. Their consistency in assigning the subjects as hypofiltrating or hyperfiltrating is unknown. In 1993 apparently healthy adolescents (53.4% females) aged 14–17 years, we investigated the concordance of six creatinine-based formulae in the classification of the subjects into ≤ 5th or ≥95th percentile of eGFR, and the between-groups difference in the prevalence of cardiometabolic risk factors. Mean eGFR varied between 77 and 121 mL/min/1.73 m2. Arbitrary setting of hypofiltration or hyperfiltration to 5% returned 46 males and 53 females. At least one formula classified 89 males and 99 females as hypofiltrating and 105 males and 114 females as hyperfiltrating. All six formulae concordantly classified 15 males and 17 females as hypofiltrating and 9 and 14, respectively, as hyperfiltrating. Pairwise, formulae consistently classified hypofiltration in 42–87% of subjects with hyperfiltration in 28–94%. According to two out of the six formulae, hyperfiltration was associated with an increased prevalence of obesity and obesity-associated comorbidities. Hypofiltrating subjects did not manifest chronic kidney disease–associated comorbidities. Further studies in different populations of healthy adolescents are needed before it is possible to conclude which creatinine-based formula is appropriate for the classification of hypofiltration and hyperfiltration in nonclinical cohorts.
Highlights
The worldwide increasing prevalence of hypertension and obesity in juveniles may predispose them to a rise in the manifestation of chronic kidney disease
We compared serum creatinine–based estimated glomerular filtration rate (eGFR) values obtained by six different equations in a large cohort of apparently healthy adolescents
We studied whether individuals with eGFR ≤ 5th percentile present morbidities that are commonly associated with decreased renal function and whether those displaying eGFR ≥ 95th percentile present obesity and obesity-associated risk markers
Summary
The worldwide increasing prevalence of hypertension and obesity in juveniles may predispose them to a rise in the manifestation of chronic kidney disease. Studies in the general population of children and adolescents and pediatric patients with type 1 diabetes (T1D) comprehensively document the disparities and errors between measured and estimated GFR and show that different equations to estimate GFR return values in a broad range [13,14,15,16] It remains unclear whether different formulae consistently categorize adolescents into the lower and upper tail of eGFR distribution. Concordance in assigning is of clinical importance as a manifestation of low or high eGFR requires further diagnostic steps To these points, we compared serum creatinine–based eGFR values obtained by six different equations in a large cohort of apparently healthy adolescents. Analyses were performed by using the SPSS v.16 for Windows software (SPSS Inc., Chicago, IL, USA)
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