P0110 / #800: MEASURED GLOMERULAR FILTRATION RATE USING DTPA PLASMA CLEARANCE VERSUS ESTIMATED GLOMERULAR FILTRATION RATE USING MODIFIED SCHWARTZ FORMULA IN CRITICALLY ILL CHILDREN: A OBSERVATIONAL STUDY

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Aims & Objectives: To study the strength of agreement between the Measured (m-GFR) by 99mTc-DTPA renal clearance and Estimated GFR (e-GFR) by modified Schwartz formula in critically ill children in PICU. Methods: Children aged 1 month to 12 years admitted in PICU, were included in the study within 24 hours of admission to PICU with stable hemodynamic parameters. One mCi (mile Curie) of freshly prepared 99mTc-DTPA dispensed in pre-weighed syringes was injected intravenously followed by 2 ml of normal saline flush.Two blood samples for GFR estimation and simultaneous SCr were taken at two hour and four-hour following injection in a heparinized vial. The counting of samples was done within by Russell’s two-sample slope-intercept method was performed. GFR was calculated as follows by using the modified Schwartz formula, e-GFR = k x L / Sr Results: Bland–Altman plot for GFR by 99mTc-DTPA plasma clearance and bedside Schwartz method showed a mean difference of 4.538 (95% confidence interval [CI] = -0.388–8.895). The limit of agreement ranged from -61.32to 69.87. ICC coefficient in our study showed moderate correlation in the whole study group, in subjects more than 24 months of age and in patients suffering from AKI.One thirty-one (64.8%) patients were diagnosed with AKI as per p-RIFLE classification.One hundred twenty-seven patients (62.87%) diagnosed AKI within 24 hours of PICU stay by using bedside Schwartz formula and 117 of them also matching AKI criteria if GFR was considered as per m-GFR value. Conclusions: We found good agreement between measured and estimated GFR in pediatric patients.