Journal
PEDIATRIC NEPHROLOGY
Volume 33, Issue 2, Pages 315-323Publisher
SPRINGER
DOI: 10.1007/s00467-017-3802-5
Keywords
Chronic kidney disease; Child; Uremic toxins; Glomerular filtration rate
Categories
Funding
- Agency for Innovation by Science and Technology (IWT)
- Applied Biomedical Research with a Primary Societal Goal (TBM) program in Flanders (Belgium): UToPaed project [IWT-TBM 150195]
Ask authors/readers for more resources
Chronic kidney disease (CKD) in childhood is characterised by the accumulation of uraemic toxins resulting in a multisystem disorder that has a negative impact on quality of life. Childhood CKD is predominantly defined by a decrease in glomerular filtration rate, estimated (eGFR) by a single serum measurement of endogenous biomarkers, e.g. creatinine. The objective of this study was to evaluate how accurately eGFR predicts the concentration of uraemic toxins in a paediatric CKD cohort. In 65 children (10.8 [5.1; 14.7] years) with CKD (eGFR 44 [20; 64] mL/min/1.73 m(2)), serum concentrations were determined of small solutes (uric acid [UA], urea, symmetric dimethylarginine [SDMA], asymmetric dimethylarginine [ADMA]), middle molecules (beta 2-microglobulin [beta 2M], complement factor D [CfD]) and protein-bound solutes (p-cresylglucuronide [pCG], hippuric acid, indole acetic acid, indoxyl sulphate [IxS], p-cresylsulfate [pCS] and 3-carboxy-4-methyl-5-propyl-furanpropionic acid [CMPF]). Spearman's correlation coefficients (r) were calculated to correlate uraemic toxin concentrations with three different eGFR equations, based on either serum creatinine or beta 2M. Updated Schwartz eGFR was correlated reasonably well with concentrations of creatinine (r = -0.98), urea (r(s) = -0.84), SDMA (r = -0.82) and middle molecules CfD and beta 2M (both r(s) = -0.90). In contrast, poor correlation coefficients were found for CMPF (r(s) = -0.32), UA (r(s) = -0.45), ADMA (r(s) = -0.47) and pCG (r(s) = -0.48). The other toxins, all protein-bound, had r(s) between -0.75 and -0.57. Comparable correlations were found between the three evaluated eGFR equations and uraemic toxin concentrations. This study demonstrates that eGFR poorly predicts concentrations of protein-bound uraemic toxins, UA and ADMA in childhood CKD. Therefore, eGFR only partially reflects the complexity of the accumulation pattern of uraemic toxins in childhood CKD.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available