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Published in: Pediatric Nephrology 5/2015

01-05-2015 | Original Article

Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m2

Authors: Hans Pottel, Liesbeth Hoste, Pierre Delanaye

Published in: Pediatric Nephrology | Issue 5/2015

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Abstract

Background

The chronic kidney disease (CKD) classification system for children is similar to that for adults, with both mainly based on estimated glomerular filtration rate (eGFR) combined with fixed cut-off values. The main cut-off eGFR value used to define CKD is 60 mL/min/1.73 m2, a value that is also applied for children older than 2 years of age, adolescents and young adults.

Methods

Based on a literature search, we evaluated inclusion criteria for eGFR in clinical trials or research studies on CKD for children. We also collected information on direct measurements of GFR (mGFR) in children and adolescents, with the aim to estimate the normal reference range for GFR. Using serum creatinine (Scr) normal reference values and Scr-based eGFR-equations, we also evaluated the correspondence between Scr normal reference values and (e)GFR normal reference values.

Results

Based on our literature search, the inclusion of children in published CKD studies has been based on cut-off values for eGFR of >60 mL/min/1.73 m2. The lower reference limits for mGFR far exceed this adult threshold. Using eGFR values calculated using Scr-based formulas, we found that abnormal Scr levels in children already correspond to eGFR values that are below a cut-off of 75 mL/min/1.73 m2.

Conclusions

Abnormal GFR in children, adolescents and young adults starts below 75 mL/min/1.73 m2, and as abnormality is a sign of disease, we recommend referring children, adolescents and young adults with an (e)GFR of <75 mL/min/1.73 m2 for further clinical assessment.
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Metadata
Title
Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m2
Authors
Hans Pottel
Liesbeth Hoste
Pierre Delanaye
Publication date
01-05-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 5/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-014-3002-5

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