1 Aalborg University Hospital, The Faculty of Medicine, Aalborg University, VBN2 Klinik Diagnostik, The Faculty of Medicine, Aalborg University, VBN3 Klinisk Fysiologi og Nuklearmedicin, The Faculty of Medicine, Aalborg University, VBN4 The Faculty of Medicine, Aalborg University, VBN5 unknown6 Institut for Klinisk Medicin - Klinisk fysiologi og nuclearmedicin, SKS
Comparison of GFR-models and serum markers
Background The aim of this study was to compare the ability of renal indicators [serum creatinine (SCr), cystatin C (SCysC)] and glomerular filtration rate (GFR)-models to discriminate normal and reduced renal function. As a single cut-off level will always lead to false classifications, we propose using two cut-off levels, dividing renal function into normal or reduced, with an intermediate "gray zone" of indeterminable results.Methods Glomerular filtration rate was measured by plasma clearance of 51Cr-EDTA (13.7–147.4 mL/min/1.73 m2) in 119 children (age range 2.3–14.9 years).Reduced renal function was defined as a GFR of<82 mL/min/1.73 m2. SCr, SCysC, age-normalized creatinine (SCr-ratio), and eight published GFR-models were compared for their ability to correctly classify renal function as normal or reduced. Cut-off levels were determined so as to give 99 % certainty outside the gray zone.Results The multivariable GFR-models by Schwartz et al. (J Am Soc Nephrol 2009; 20:629–637) and Zappitelli et al. (Am J Kidney Dis 2006; 48:221–230) and two models by Andersen et al. [Am J Kidney Dis 2012; 59(1):50–57: body cell mass (BCM)-model and Weight-model] performed significantly better than all other variables (P<0.01), with the BCM-model performing the best (P<0.05). The SCr-based Schwartz formula and SCr-ratio both performed better than SCr and SCysC.Conclusions Among the 119 children enrolled in this study and the renal indicators tested, the BCM-model had the best diagnostic performance in terms of screeningor normal or reduced renal function, and the SCr-ratio was a superiordiagnostic tool to both SCr and SCysC.
Pediatric Nephrology, 2013, Vol 28, Issue 1, p. 83-92
Adolescent; Child; Child, Preschool; Creatinine; Cystatin C; Female; Glomerular Filtration Rate; Humans; Kidney Diseases; Kidney Function Tests; Male