Can the height-independent Pottel eGFR equation be used as a screening tool for chronic kidney disease in children?

Eur J Pediatr. 2015 Sep;174(9):1225-35. doi: 10.1007/s00431-015-2523-7. Epub 2015 Apr 7.

Abstract

Determination of plasma creatinine (Pcr) should be associated to an estimation of glomerular filtration rate (eGFR). Pottel et al. established a height-independent equation, eGFR = 107.3/(Pcr/Q) where Q is the median of Pcr (Pottel-Belgium). The aims were to 1) determine a local height-independent equation (Pottel-Lyon), 2) evaluate the performance of these equations compared to the Schwartz 2009 and Schwartz-Lyon equations, and 3) evaluate the height-independent equations in laboratory routine. Therefore, 1) all first pediatric Pcr determination (December 2009-June 2011) were collected, and median of Pcr was determined for each 1-year age interval (Q-Lyon), 2) GFR was measured (mGFR) in 359 children (438 measures) and compared to eGFR, and 3) all first Pcr determination (January 2012-June 2013) were used to calculate eGFR with the Pottel-Lyon and the Pottel-Belgium equations. Pcr was determined by an IDMS-standardized enzymatic assay. In the population with a mGFR, the Pottel-Lyon and the Schwartz-Lyon showed the best performance (bias, P10 and P30). However, the performance in identifying patients with a mGFR < 75 mL/min/1.73 m(2) was similar for all the studied equations.

Conclusion: The performance of the height-independent and dependent equations to identify mild renal dysfunction is similar. The height-independent Pottel equation could be proposed as an excellent screening tool for kidney disease when height information is not available. "

What is known: " • Determination of plasma creatinine in children is rarely associated to an estimation of glomerular filtration rate due to the lack of height information. • Pottel et al. developed a height-independent equation (eGFR = 107.3/(Pcr/Q) where Q is the median of Pcr for each age class. "

What is new: " • The performance of the height-independent (Pottel) or height-dependent (Schwartz) equations is similar to identify renal dysfunction (GFR < 75 mL/min/1.73 m (2) ) in children. • The height-independent Pottel equation could be an excellent screening tool for kidney disease in a general pediatric laboratory when height information is not available.

MeSH terms

  • Adolescent
  • Belgium / epidemiology
  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Creatinine / blood*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Infant
  • Kidney / physiopathology
  • Male
  • Mass Screening*
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / physiopathology*
  • Retrospective Studies

Substances

  • Biomarkers
  • Creatinine