Skip to content
Licensed Unlicensed Requires Authentication Published by De Gruyter March 15, 2017

Efficient reporting of the estimated glomerular filtration rate without height in pediatric patients with cancer

  • Tae-Dong Jeong , Eun-Jung Cho , Woochang Lee , Sail Chun , Ki-Sook Hong and Won-Ki Min EMAIL logo

Abstract:

Background:

The updated bedside Schwartz equation requires constant, serum creatinine concentration and height measurements to calculate the estimated glomerular filtration rate (eGFR) in pediatric patients. Unlike the serum creatinine levels, obtaining height information from the laboratory information system (LIS) is not always possible in a clinical laboratory. Recently, the height-independent eGFR equation, the full age spectrum (FAS) equation, has been introduced. We evaluated the performance of height-independent eGFR equation in Korean children with cancer.

Methods:

A total of 250 children who underwent chromium-51-ethylenediamine tetra acetic-acid (51Cr-EDTA)-based glomerular filtration rate (GFR) measurements were enrolled. The 51Cr-EDTA GFR was used as the reference GFR. The bias (eGFR – measured GFR), precision (root mean square error [RMSE]) and accuracy (P30) of the FAS equations were compared to those of the updated Schwartz equation. P30 was defined as the percentage of patients whose eGFR was within ±30% of the measured GFR.

Results:

The FAS equation showed significantly lower bias (mL/min/1.73 m2) than the updated Schwartz equation (4.2 vs. 8.7, p<0.001). The RMSE and P30 were: updated Schwartz of 43.8 and 64.4%, respectively, and FAS of 42.7 and 66.8%, respectively.

Conclusions:

The height-independent eGFR-FAS equation was less biased and as accurate as the updated Schwartz equation in Korean children. The use of the height-independent eGFR equation will allow for efficient reporting of eGFR through the LIS in clinical laboratories.


Corresponding author: Won-Ki Min, MD, PhD, Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center. 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea, Phone: 82-2-3010-4503, Fax: 82-2-478-0884

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2013;3:1–150.Search in Google Scholar

2. Hoste L, Dubourg L, Selistre L, De Souza VC, Ranchin B, Hadj-Aïssa A, et al. A new equation to estimate the glomerular filtration rate in children, adolescents and young adults. Nephrol Dial Transplant 2014;29:1082–91.10.1093/ndt/gft277Search in Google Scholar PubMed

3. Pottel H, Hoste L, Martens F. A simple height-independent equation for estimating glomerular filtration rate in children. Pediatr Nephrol 2012;27:973–9.10.1007/s00467-011-2081-9Search in Google Scholar PubMed

4. Pottel H, Hoste L, Dubourg L, Ebert N, Schaeffner E, Eriksen BO, et al. An estimated glomerular filtration rate equation for the full age spectrum. Nephrol Dial Transplant 2016;31:798–806.10.1093/ndt/gfv454Search in Google Scholar PubMed PubMed Central

5. Cole M, Price L, Parry A, Keir MJ, Pearson AD, Boddy AV, et al. Estimation of glomerular filtration rate in paediatric cancer patients using 51CR-EDTA population pharmacokinetics. Br J Cancer 2004;90:60–4.10.1038/sj.bjc.6601484Search in Google Scholar PubMed PubMed Central

6. Mattman A, Eintracht S, Mock T, Schick G, Seccombe DW, Hurley RM, et al. Estimating pediatric glomerular filtration rates in the era of chronic kidney disease staging. J Am Soc Nephrol 2006;17:487–96.10.1681/ASN.2005010034Search in Google Scholar PubMed

7. Jeong TD, Lee W, Yun YM, Chun S, Song J, Min WK. Development and validation of the Korean version of CKD-EPI equation to estimate glomerular filtration rate. Clin Biochem 2016;49:713–9.10.1016/j.clinbiochem.2016.01.023Search in Google Scholar PubMed

8. Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20:629–37.10.1681/ASN.2008030287Search in Google Scholar PubMed PubMed Central

9. Piepsz A, Tondeur M, Ham H. Escaping the correction for body surface area when calculating glomerular filtration rate in children. Eur J Nucl Med Mol Imaging 2008;35:1669–72.10.1007/s00259-008-0820-3Search in Google Scholar PubMed

10. Schwartz GJ, Work DF. Measurement and estimation of GFR in children and adolescents. Clin J Am Soc Nephrol 2009;4:1832–43.10.2215/CJN.01640309Search in Google Scholar PubMed

11. Miller WG. Estimating equations for glomerular filtration rate in children: laboratory considerations. Clin Chem 2009;55:402–3.10.1373/clinchem.2008.122218Search in Google Scholar PubMed

12. Blufpand HN, Westland R, van Wijk JA, Roelandse-Koop EA, Kaspers GJ, Bökenkamp A. Height-independent estimation of glomerular filtration rate in children: an alternative to the Schwartz equation. J Pediatr 2013;163:1722–7.10.1016/j.jpeds.2013.08.031Search in Google Scholar PubMed

13. Staples A, LeBlond R, Watkins S, Wong C, Brandt J. Validation of the revised Schwartz estimating equation in a predominantly non-CKD population. Pediatr Nephrol 2010;25:2321–6.10.1007/s00467-010-1598-7Search in Google Scholar PubMed

14. Earley A, Miskulin D, Lamb EJ, Levey AS, Uhlig K. Estimating equations for glomerular filtration rate in the era of creatinine standardization. Ann Intern Med 2012;156:785–95.10.7326/0003-4819-156-11-201203200-00391Search in Google Scholar PubMed


Supplemental Material:

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2016-1151).


Received: 2016-12-19
Accepted: 2017-2-1
Published Online: 2017-3-15
Published in Print: 2017-10-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

Downloaded on 1.6.2024 from https://www.degruyter.com/document/doi/10.1515/cclm-2016-1151/html
Scroll to top button