Abstract
Equations for estimating glomerular filtration rate (GFR) are vital in caring for patients with renal disease and the current standard, the Schwartz formula, lacks precision. We evaluated several child serum creatinine-based GFR prediction equations. Subjects aged 2-21 years who underwent iothalamate GFR (IoGFR) testing between 1999 and 2004 were studied retrospectively. GFR was estimated using: (1) Schwartz formula (SchwartzGFR), using a local k value; (2) Schwartz model (SchwartzMod) using regression-derived coefficients; (3) Leger GFR (LegerGFR) using original coefficients; and (4) Leger model (LegerMod) using regression-derived coefficients. Bias, precision, and diagnostic characteristics were evaluated. There were 195 subjects [61% male; mean (SD) age 12.4 (4.5) years; mean (SD) IoGFR 78.9 (33.4) ml/min per 1.73 m(2)]. Only the LegerGFR overestimated IoGFR (5.5 ml/min per 1.73 m(2)). Precision for all formulae was poor (95% limits of agreement approximately -40 to 40 ml/min per 1.73 m(2)), but >or=72% of estimates were within 30% of IoGFR. Sensitivities for detecting IoGFR <30 and 90 ml/min per 1.73 m(2) were highest using the SchwartzGFR (80%) and SchwartzMod (90%), respectively. The LegerGFR was most specific. Using local coefficients, the Schwartz and Leger models were imprecise estimates of GFR, but the Schwartz model was most unbiased and sensitive. Future research should derive more precise equations for GFR in children.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.