Yan Ruohua, Wang Xiaowen, Zhang Chao, Wang Chen, Peng Yaguang, Huang Lin, Pottel Hans, Wang Fang, Peng Xiaoxia
Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Nephrology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Pediatr Nephrol. 2025 May 31. doi: 10.1007/s00467-025-06818-x.
This study aimed to adapt the existing Q-based equation for glomerular filtration rate (GFR) estimation using serum creatinine (SCr) to Chinese children by modification of certain parameters, and to establish the pediatric reference intervals (RIs) for estimated GFR in China accordingly.
The Q-based equation had the form eGFR = M/(SCr/Q), where the parameter M was estimated from 328 children with measured GFR in Wuhan Children's Hospital, and the parameter Q was fitted among 11,713 healthy children volunteers who had SCr recruited from 11 provinces of China. The Q-based equation was applied to 60,524 inpatients in Beijing Children's Hospital to assess the impact of estimated GFR on the clinical diagnosis of acute kidney injury (AKI). Then, the Q-based equation was used to estimate GFR in a large representative population of healthy Chinese children for RI establishment.
The parameter M was estimated separately in children aged less than 2 years (100.2) and 2 years or above (107.3). The parameter Q was modeled as a linear function of age in boys (19.5 + 3.2Age) and girls (23.6 + 2.2Age), respectively. The GFR estimated by the Q-based equation could well identify AKI, with a significantly higher risk of in-hospital mortality in AKI patients than non-AKI patients (OR, 5.69; 95% CI, 4.80-6.74). The RI of estimated GFR for children aged 2 years or above ranged from 82.5 to 145.2 ml/min/1.73 m, comparable to that for young adults (80 to 140 ml/min/1.73 m).
The Q-based equation is simple and practical for GFR estimation in Chinese children.
本研究旨在通过修改某些参数，使现有的基于血清肌酐（SCr）估算肾小球滤过率（GFR）的Q方程适用于中国儿童，并据此建立中国儿童估算GFR的儿科参考区间（RIs）。
基于Q的方程形式为eGFR = M/(SCr/Q)，其中参数M是根据武汉儿童医院328例测量了GFR的儿童估算得出，参数Q是在从中国11个省份招募的11713名有SCr测量值的健康儿童志愿者中拟合得到。将基于Q的方程应用于北京儿童医院的60524例住院患者，以评估估算GFR对急性肾损伤（AKI）临床诊断的影响。然后，使用基于Q的方程估算大量具有代表性的中国健康儿童群体的GFR，以建立参考区间。
参数M在2岁以下儿童（100.2）和2岁及以上儿童（107.3）中分别估算得出。参数Q分别被建模为男孩（19.5 + 3.2年龄）和女孩（23.6 + 2.2年龄）年龄的线性函数。基于Q的方程估算的GFR能够很好地识别AKI，AKI患者的院内死亡风险显著高于非AKI患者（OR，5.69；95% CI，4.80 - 6.74）。2岁及以上儿童估算GFR的参考区间为82.5至145.2 ml/min/1.73 m²，与年轻成年人（80至140 ml/min/1.73 m²）相当。
基于Q的方程在中国儿童GFR估算中简单实用。
