[en] [en] BACKGROUND: Serum creatinine (SCr), the most used biomarker to evaluate glomerular filtration rate (GFR), might be inaccurate in children with sickle cell anemia (SCA). In this context, cystatin C (SCys) could be of interest. This study evaluated the performance of commonly used SCr- and SCys-based estimated GFR (eGFR) equations in African children with SCA.
METHODS: This cross-sectional study included 109 steady-state children with SCA aged 3-18 years, from the Democratic Republic of Congo. Measured GFR (mGFR) was obtained using iohexol plasma clearance. eGFR was calculated using commonly used SCr- and SCys-based equations in children. The performance of these equations was evaluated by calculating the bias, precision, and accuracy within 30% (P30) of mGFR.
RESULTS: The mean age of participants was 9.9 ± 4.2 years, and 48.6% were female. The median mGFR was 142 (IQR 119-169) mL/min/1.73 m2. Of the equations studied, the FAS-Age SCr had the lowest bias (0.9 mL/min/1.73 m2). However, the 95% limit of agreement was very wide (-80.3 to + 81.6). SCr failed to rise in an age-dependent manner, reflecting a progressive loss of muscle mass or increased tubular secretion. All SCys-based equations underestimated GFR and failed to detect hyperfiltration, but there was no age-related change in bias.
CONCLUSION: These data show that all common eGFR equations using SCr or SCys poorly predict mGFR in African children with SCA. SCr-based equations potentially miss a decline in kidney function, which suggests that SCys could be the preferred marker in this population.
Disciplines :
Urology & nephrology
Author, co-author :
Nkoy, Agathe Bikupe ; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo. agath.nkoy@gmail.com ; Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium. agath.nkoy@gmail.com
Mumaka, Floreen Maluwenze; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo
Matoka, Therance Tobo; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo
Ngonde, Ange; REZODREPANO SS, Kinshasa, Democratic Republic of Congo
Sumaili, Ernest Kiswaya ; Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo
Bukabau, Justine Busanga ; Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo
Labarque, Veerle ; Department of Pediatric Hematology, University Hospital Leuven, Leuven, Belgium ; Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
van den Heuvel, Lambertus P ; Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium ; Department of Pediatric Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands
Bökenkamp, Arend ; Department of Pediatric Nephrology, Amsterdam University Medical Center, Amsterdam, The Netherlands
Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale
Levtchenko, Elena ; Department of Pediatric Nephrology, Amsterdam University Medical Center, Amsterdam, The Netherlands
Delanaye, Pierre ; Université de Liège - ULiège > Département des sciences cliniques > Néphrologie ; Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
Pottel, Hans ; Université de Liège - ULiège > Département des sciences cliniques ; Department of Public Health and Primary Care, KU Leuven Campus Kulak, Kortrijk, Belgium
Ekulu, Pépé Mfutu ; Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo
VLIR-UOS - Flemish Interuniversity Council. Bureau UOS ULiège - Université de Liège
Funding text :
A.B.N. was supported by the Global Minds Scholarship of VLIR-UOS and DGD (Belgium partner in development). Iohexol, enzymatic serum creatinine, and serum cystatin C measurements were supported by funding from the University of Li\u00E8ge.
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