2008 JASN IMPACT FACTOR 7.505	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2008030287v1 20/3/629    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schwartz, G. J. Articles by Furth, S. L. Search for Related Content PubMed PubMed Citation Articles by Schwartz, G. J. Articles by Furth, S. L.

New Equations to Estimate GFR in Children with CKD

George J. Schwartz^*, Alvaro Muñoz, Michael F. Schneider, Robert H. Mak, Frederick Kaskel, Bradley A. Warady^|| and Susan L. Furth^,¶

^* Department of Pediatrics, University of Rochester School of Medicine, Rochester, and Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and ^¶ Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Pediatrics, Children's Hospital of San Diego, San Diego, California; ^|| Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri

Correspondence: Dr. George J. Schwartz, Professor of Pediatrics and of Medicine, Chief, Pediatric Nephrology, Box 777, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642. Phone: 585-275-9784; Fax: 585-756-8054; E-mail: george_schwartz{at}urmc.rochester.edu

Received for publication March 12, 2008. Accepted for publication August 26, 2008.

The Schwartz formula was devised in the mid-1970s to estimate GFR in children. Recent data suggest that this formula currently overestimates GFR as measured by plasma disappearance of iohexol, likely a result of a change in methods used to measure creatinine. Here, we developed equations to estimate GFR using data from the baseline visits of 349 children (aged 1 to 16 yr) in the Chronic Kidney Disease in Children (CKiD) cohort. Median iohexol-GFR (iGFR) was 41.3 ml/min per 1.73 m² (interquartile range 32.0 to 51.7), and median serum creatinine was 1.3 mg/dl. We performed linear regression analyses assessing precision, goodness of fit, and accuracy to develop improvements in the GFR estimating formula, which was based on height, serum creatinine, cystatin C, blood urea nitrogen, and gender. The best equation was

This formula yielded 87.7% of estimated GFR within 30% of the iGFR, and 45.6% within 10%. In a test set of 168 CKiD patients at 1 yr of follow-up, this formula compared favorably with previously published estimating equations for children. Furthermore, with height measured in cm, a bedside calculation of 0.413*(height/serum creatinine), provides a good approximation to the estimated GFR formula. Additional studies of children with higher GFR are needed to validate these formulas for use in screening all children for CKD.

This article has been cited by other articles:

				J. J. Fadrowski, A. Navas-Acien, M. Tellez-Plaza, E. Guallar, V. M. Weaver, and S. L. Furth Blood Lead Level and Kidney Function in US Adolescents: The Third National Health and Nutrition Examination Survey Arch Intern Med, January 11, 2010; 170(1): 75 - 82. [Abstract] [Full Text] [PDF]

				C. Tondel, U. Ramaswami, K. M. Aakre, F. Wijburg, M. Bouwman, and E. Svarstad Monitoring renal function in children with Fabry disease: comparisons of measured and creatinine-based estimated glomerular filtration rate Nephrol. Dial. Transplant., December 27, 2009; (2009) gfp658v1. [Abstract] [Full Text] [PDF]

				A. G. Abraham, G. J. Schwartz, S. Furth, B. A. Warady, and A. Munoz Longitudinal Formulas to Estimate GFR in Children with CKD Clin. J. Am. Soc. Nephrol., November 1, 2009; 4(11): 1724 - 1730. [Abstract] [Full Text] [PDF]

				G. J. Schwartz and D. F. Work Measurement and Estimation of GFR in Children and Adolescents Clin. J. Am. Soc. Nephrol., November 1, 2009; 4(11): 1832 - 1843. [Abstract] [Full Text] [PDF]

				J. R. Ingelfinger Blood-Pressure Control and Delay in Progression of Kidney Disease in Children N. Engl. J. Med., October 22, 2009; 361(17): 1701 - 1703. [Full Text] [PDF]

Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673