Creatinine; Cystatin C; Estimating GFR; Full age range equation; Pediatrics, Perinatology and Child Health; Nephrology
Abstract :
[en] [en] BACKGROUND: A new cystatin C based European Kidney Function Consortium (EKFCCysC) equation was recently developed for adults, using the same mathematical form as the previously published full age spectrum creatinine based EKFC-equation (EKFCCrea). In the present study the cystatin C based EKFC-equation is extended to children, by defining the appropriate cystatin C rescaling factor QCysC.
METHODS: Rescaling factor QCysC for cystatin C was defined as: a) 0.83 mg/L, exactly as it was defined for young adults in the adult equation, and b) a more complex QCysC-age relationship based on 4th degree cystatin C-age polynomials after evaluation of data from Uppsala, Stockholm and Canada and aggregated data from Germany. The EKFCCysC equation was then validated in an independent dataset in European children (n = 2,293) with measured GFR, creatinine, cystatin C, age, height and sex available.
RESULTS: The EKFCCysC with the simple QCysC-value of 0.83 had a bias of -7.6 [95%CI -8.4;-6.5] mL/min/1.73 m2 and a P30-value of 85.8% [95%CI 84.4;87.3] equal to the EKFCCysC with the more complex 4th degree QCysC-value. The arithmetic mean of the EKFCCrea and EKFCCysC with the simple QCysC of 0.83 had a bias of -4.0 [95%CI -4.5;-3.1] mL/min/1.73 m2 and P30 of 90.4% [95%CI 89.2;91.6] similar to using the more complex 4th degree QCysC-polynomial.
CONCLUSION: Using exactly the same QCysC of 0.83 mg/L, the adult EKFCCysC can easily be extended to children, with some bias but acceptable P30-values. The arithmetic mean of EKFCCrea and EKFCCysC results in bias closer to zero and P30 slightly over 90%. A higher resolution version of the Graphical abstract is available as Supplementary information.
Disciplines :
Laboratory medicine & medical technology Urology & nephrology Pediatrics
Author, co-author :
Pottel, Hans ; Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium. Hans.Pottel@kuleuven-kulak.be
Nyman, Ulf; Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
Björk, Jonas; Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden ; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
Berg, Ulla; Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
Bökenkamp, Arend; Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Dubourg, Laurence Derain; Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, and Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, Université Claude Bernard Lyon 1, Lyon, France
Lemoine, Sandrine; Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, and Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, Université Claude Bernard Lyon 1, Lyon, France
Goffin, Karolien; Department of Nuclear Medicine, Division of Nuclear Medicine and Molecular Imaging, University Hospital Leuven, KU Leuven, Louvain, Belgium
Grubb, Anders; Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
Hansson, Magnus; Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
Larsson, Anders; Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
Littmann, Karin; Department of Medicine Huddinge, and Medical Unit of Endocrinology, Theme Inflammation and Ageing, Karolinska Institutet, Stockholm, Sweden, Karolinska University Hospital, Stockholm, Sweden
Åsling-Monemi, Kajsa; Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
Adeli, Khosrow; Clinical Biochemistry, Paediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Canada
Cavalier, Etienne ; Centre Hospitalier Universitaire de Liège - CHU > > Service de chimie clinique
Delanaye, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > > Service de néphrologie ; Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nîmes, France
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