Paediatric Endocrinology and Diabetology, University Children's Hospital, University of Berne, Berne, Switzerland.
Department of General Paediatrics and Neonatology, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany.
Front Endocrinol (Lausanne). 2020 Feb 21;11:52. doi: 10.3389/fendo.2020.00052. eCollection 2020.
To apply and evaluate various equations for estimated glomerular filtration rates (eGFR) in a large paediatric type 1 diabetes population and compare the eGFR values with urinary creatinine clearances (UCC) in a subset of patients. Six eGFR formulae applicable for children and adolescents were used for calculation of eGFR values in 36,782 children/adolescents with type 1 diabetes. Via regression models, factors influencing eGFR values were identified. eGFR values were compared with measured UCC in 549 patients. Spearman correlation coefficients were given to assess the relation of eGFR and UCC values. Bland-Altman-Plots with corresponding linear regression were drawn to evaluate the agreement between eGFR and UCC. eGFR values differed widely depending on the formula used, resulting in a percentage of pathological values <60 mL/min/1.73 m up to 8%. Regression models showed age, sex, and duration of diabetes as influencing factors. Microalbuminuria was associated with significantly higher eGFR values for all formulae. In comparison of eGFR with UCC, the highest correlation coefficient was 0.33, the lowest 0.01. Bland-Altman-Plots demonstrated graphically a poor agreement between eGFR and UCC, regardless of the formula used. The broad range of eGFR values indicate that an ideal eGFR formula for children and adolescence with T1D is yet missing. The minimal agreement between measured UCC and eGFR values urges us to be careful in application and interpretation of eGFR values regardless of the formula used.
应用并评估了适用于大型儿科 1 型糖尿病人群的肾小球滤过率（eGFR）的各种方程，并在一部分患者中比较了 eGFR 值与尿肌酐清除率（UCC）的相关性。 该研究使用了 6 种适用于儿童和青少年的 eGFR 公式，计算了 36782 例 1 型糖尿病患儿和青少年的 eGFR 值。通过回归模型，确定了影响 eGFR 值的因素。在 549 例患者中，将 eGFR 值与实测 UCC 进行了比较。给出了斯皮尔曼相关系数来评估 eGFR 值与 UCC 值的相关性。绘制 Bland-Altman 图并进行相应的线性回归，以评估 eGFR 与 UCC 之间的一致性。 由于使用的公式不同，eGFR 值差异很大，导致 <60 mL/min/1.73 m2 的病理性值百分比高达 8%。回归模型显示年龄、性别和糖尿病病程是影响因素。所有公式中，微量白蛋白尿与 eGFR 值显著升高相关。与 UCC 相比，eGFR 值的相关系数最高为 0.33，最低为 0.01。Bland-Altman 图直观地显示了 eGFR 与 UCC 之间的一致性较差，无论使用哪种公式。 eGFR 值范围广泛，表明目前尚缺乏适用于 1 型糖尿病儿童和青少年的理想 eGFR 公式。测量的 UCC 与 eGFR 值之间的一致性很差，这促使我们在使用任何公式时都要谨慎应用和解释 eGFR 值。
