Tsampalieros Anne, Lepage Nathalie, Feber Janusz
Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
Pediatr Transplant. 2011 Nov;15(7):760-5. doi: 10.1111/j.1399-3046.2011.01568.x. Epub 2011 Aug 23.
GFR in children can be obtained from a formula using SCr and height or various formulas including serum CysC. Recently, two new GFR formulas have been developed: (i) height and SCr-mSchwartz GFR and (ii) height, SCr, CysC, and serum urea (CKiD GFR). While these formulas proved to be accurate when compared to the gold standard, their use in children post-kidney Tx is yet to be assessed. A total of 1174 blood samples (urea, SCr and CysC) were analyzed from the post-Tx period in 24 Tx children (12 boys, median age = 8.6 yr) currently followed at our institution. CKiD GFR and mSchwartz GFR were compared using Bland-Altman analysis and the CV. The mSchwartz GFR overestimated the CKiD GFR (mean bias = 1.09 ± 0.14; 95% limits of agreements from 0.82 to 1.36). Median CV of CKiD GFR (10.3%) was significantly lower than that of mSchwartz GFR (15.0%), p = 0.04, and negatively correlated with the slope of GFR (r(2) = 0.34, p = 0.0026). In conclusion, CKiD GFR has a significantly lower intraindividual variation than mSchwartz GFR and may be better suited for longitudinal follow-up of patients post-Tx.
儿童的肾小球滤过率(GFR)可以通过使用血清肌酐(SCr)和身高的公式或包括血清胱抑素C(CysC)在内的各种公式来获得。最近,开发了两种新的GFR公式:(i)身高和SCr - mSchwartz GFR以及(ii)身高、SCr、CysC和血清尿素(CKiD GFR)。虽然与金标准相比,这些公式被证明是准确的,但它们在儿童肾移植术后的应用尚未得到评估。我们机构对目前随访的24名肾移植儿童(12名男孩,中位年龄 = 8.6岁)移植后的1174份血液样本(尿素、SCr和CysC)进行了分析。使用Bland - Altman分析和变异系数(CV)对CKiD GFR和mSchwartz GFR进行了比较。mSchwartz GFR高估了CKiD GFR(平均偏差 = 1.09 ± 0.14;95%一致性界限为0.82至1.36)。CKiD GFR的中位CV(10.3%)显著低于mSchwartz GFR的中位CV(15.0%),p = 0.04,并且与GFR的斜率呈负相关(r² = 0.34,p = 0.0026)。总之,CKiD GFR的个体内变异显著低于mSchwartz GFR,可能更适合肾移植术后患者的纵向随访。