Interdisciplinary Research Center, Katholieke Universiteit Leuven Campus Kortrijk, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium.
Pediatr Nephrol. 2012 Jun;27(6):973-9. doi: 10.1007/s00467-011-2081-9. Epub 2012 Jan 18.
The chronic kidney disease (CKD) classification system for children is similar to the CKD classification system for adults, using estimated glomerular filtration rate (eGFR) combined with fixed cut-off values of 60, 30, and 15 ml/min/1.73 m(2) for CKD stages III, IV, and V, respectively. To estimate GFR in children, eGFR-equations are used that require serum creatinine (Scr), but also height information, which is normally not available in clinical laboratory databases.
This retrospective study is based on data from two different databases, one that has previously been used to develop the Flanders Metadata equation for children and one database including 353 children who underwent (51)Cr-EDTA GFR, serum creatinine, height, and weight measurements.
A height-independent eGFR equation based on the concept of a population-normalized Scr, presented before for adults, is extended to children: eGFR = 107.3/(Scr/Q), with Q the median Scr for healthy children of a particular age. This equation is validated against direct measurements of GFR, and against the updated Schwartz and Flanders Metadata equation.
The new simple height-independent equation performs very well and should make (mass) screening of kidney function in children easier.
儿童慢性肾脏病(CKD)分类系统与成人 CKD 分类系统相似,使用估算肾小球滤过率(eGFR),并结合分别为 60、30 和 15ml/min/1.73m²的固定截值来定义 CKD Ⅲ、Ⅳ和 V 期。为了估算儿童的 GFR,使用 eGFR 方程,这些方程需要血清肌酐(Scr),但也需要身高信息,而临床实验室数据库中通常没有这些信息。
本回顾性研究基于来自两个不同数据库的数据,一个是以前用于开发儿童 Flanders 元数据方程的数据库,另一个是包括 353 名接受过(51)Cr-EDTA GFR、血清肌酐、身高和体重测量的儿童的数据库。
一个基于人群标准化 Scr 概念的、之前已提出的适用于成人的不依赖身高的 eGFR 方程被扩展到儿童:eGFR=107.3/(Scr/Q),其中 Q 是特定年龄健康儿童的中位数 Scr。该方程通过与直接测量的 GFR 以及更新的 Schwartz 和 Flanders 元数据方程进行验证。
新的简单不依赖身高的方程表现非常好,应该使儿童肾功能的(大规模)筛查变得更容易。