A new equation to estimate the glomerular filtration rate in children, adolescents and young adults

Nephrol Dial Transplant. 2014 May;29(5):1082-91. doi: 10.1093/ndt/gft277. Epub 2013 Sep 17.

Abstract

Background: A new estimated glomerular filtration rate (eGFR) equation, designed for isotope dilution mass spectrometry-standardized serum creatinine (Scr), is presented for use in children, adolescent boys and girls and young adults.

Methods: The new equation, eGFR = 107.3/(Scr/Q), is based on the concept of normalized Scr: Q is the normalization value and is considered as the Scr concentration for the average healthy child, adolescent or young adult of a specific height (L) and is modeled as a height-dependent polynomial of the fourth degree.

Results: The well-known Schwartz equation [eGFR = kL/Scr, k = 0.413 (Schwartz) or k = 0.373 (Schwartz-Lyon)] for children between 1 and 14 years can be seen as a special case of the new equation for which the Q-polynomial is simplified to a linear equation: Q = 0.0035 × L (cm). The new eGFR equation has been validated in a data set of n = 750 children, adolescents and young adults aged 10-25, against the true GFR (inulin method), and outperforms the selected (but most used) creatinine-based eGFR equations for children, mainly in the healthy GFR region.

Conclusions: The new Q(height)-eGFR equation serves as an excellent screening tool for kidney disease in 1-25-year-old children, adolescents and young adults.

Keywords: adolescents; children; estimated glomerular filtration rate; inulin; young adults.

MeSH terms

  • Adolescent
  • Adult
  • Algorithms
  • Biomarkers / blood*
  • Child
  • Child, Preschool
  • Creatinine / blood*
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Infant
  • Kidney Diseases / blood
  • Kidney Diseases / diagnosis*
  • Male
  • Models, Theoretical*
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Young Adult

Substances

  • Biomarkers
  • Creatinine