期刊
KIDNEY INTERNATIONAL
卷 82, 期 4, 页码 445-453出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/ki.2012.169
关键词
children; chronic kidney disease; clinical nephrology; glomerular filtration rate; pediatric nephrology
资金
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute of Neurological Disorders and Stroke
- National Institute of Child Health and Human Development
- National Heart, Lung, and Blood Institute [U01 DK82194, U01-DK-66143, U01-DK-66174, U01-DK-66116]
The Chronic Kidney Disease in Children study is a cohort of about 600 children with chronic kidney disease (CKD) in the United States and Canada. The independent variable for our observations was a measurement of glomerular filtration rate (GFR) by iohexol disappearance (iGFR) at the first two visits 1 year apart and during alternate years thereafter. In a previous report, we had developed GFR estimating equations utilizing serum creatinine, blood urea nitrogen, height, gender, and cystatin C measured by an immunoturbidimetric method; however, the correlation coefficient of cystatin C and GFR (-0.69) was less robust than expected. Therefore, 495 samples were re-assayed using immunonephelometry. The reciprocal of immunonephelometric cystatin C was as well correlated with iGFR as was height/serum creatinine (both 0.88). We developed a new GFR estimating equation using a random 2/3 of 965 person-visits and applied it to the remaining 1/3 as a validation data set. In the validation data set, the correlation of the estimated GFR with iGFR was 0.92 with high precision and no bias; 91 and 45% of eGFR values were within 30 and 10% of iGFR, respectively. This equation works well in children with CKD in a range of GFR from 15 to 75 ml/min per 1.73m(2). Further studies are needed to establish the applicability to children of normal stature and muscle mass, and higher GFR. Kidney International ( 2012) 82, 445- 453; doi:10.1038/ki.2012.169; published online 23 May 2012
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