Advertisement

Pediatric Nephrology

, Volume 21, Issue 12, pp 1865–1872 | Cite as

Estimating absolute glomerular filtration rate in children

  • John R. BrandtEmail author
  • Craig S. Wong
  • Jeffery D. Hanrahan
  • Clifford Qualls
  • Nancy McAfee
  • Sandra L. Watkins
Original Article

Abstract

Normal values of glomerular filtration rate (GFR) in children are often expressed in a value adjusted to adult ideal body surface area. These values work well for many clinical situations, but in infants and children, especially those with atypical body mass, they may not accurately reflect renal function. Most body composition values in children are expressed in developmentally appropriate ranges. Absolute GFR (ml/min) also changes during childhood increasing rapidly in infancy and then gradually with age and body size. Previously, we developed a bedside equation for estimating GFR (ml/min) in children that accounted for changes with age and body size, and which correlated well with steady-state cold iothalamate GFR (ml/min) measurements: GFR (ml/min) = k*sqrt[(age(months) + 6)*wt (kg)/serum Cr (mg/dl)], where k=0.95 for females and 1.05 for males. In the present study GFR (ml/min) measured by iothalamate infusion was compared by correlation analysis with estimates calculated from the above equation in 566 children. This equation provides clinicians with a simple bedside method to estimate absolute GFR (ml/min).

Keywords

Renal function Glomerular filtration rate Iothalamate Children 

References

  1. 1.
    Guignard JP, Santos F (2004) Laboratory investigations. In: Avner ED, Harmon WE, Niaudet P (eds) Pediatric nephrology, 5th edn., Lippincott Williams-Winkins, Philadelphia, pp 399–424Google Scholar
  2. 2.
    Brandt JR, Jones DR, Qualls C, McAfee N, Brewer E, Watkins SL (2003) Glomerular filtration rate in children with solid tumors: Normative values and a new method for estimation. Pediatr Hemat Onc 20:309–318CrossRefGoogle Scholar
  3. 3.
    Weber AF, Lee DW, Opheim K, Smith A (1985) Quantitation of iothalamate in serum and urine by high performance liquid chromatography. J Chromatogr 337:434–440CrossRefGoogle Scholar
  4. 4.
    Cole BR, Giangiacomo J, Ingelfinger JR, Robson AM (1972) Measurement of renal function without urine collection: a critical evaluation of the constant-infusion technic for determination on inulin and para-aminohippurate. New Engl J Med 287:1109–1114CrossRefGoogle Scholar
  5. 5.
    Heilbron DC, Holliday MA, Al-Dahwi A, Kogan BA (1991) Expressing glomerular filtration rate in children. Pediatr Nephrol 5:5–11CrossRefGoogle Scholar
  6. 6.
    Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34:571–590CrossRefGoogle Scholar
  7. 7.
    Counahan R, Chantler C, Ghazali S, Kirkwood B, Rose F, Barratt TM (1976) Estimation of glomerular filtration rate from plasma creatinine concentration in children. Arch Dis Child 51:875–878CrossRefGoogle Scholar
  8. 8.
    Haycock GB, Schwartz GJ, Wisotsky DH (1978) Geometric method for measuring body surface area: A height-weight formula validated in infants, children, and adults. J Pediatrics 93:62–66CrossRefGoogle Scholar
  9. 9.
    National Kidney Foundation (2002) K/DOQI Clinical practice guidelines for chronic kidney disease: Evaluation, classification and stratification. Am J Kidney Dis 39 [Suppl 1]:S1–S266Google Scholar
  10. 10.
    White C, Akbari A, Hussain N, Dinh L, Filler G, Legape N, Knoll GA (2005) Estimating glomerular filtration rate in kidney transplantation: A comparison between serum creatinine and cystatin C-based methods. J Am Soc Nephrol 16:3763–3770CrossRefGoogle Scholar
  11. 11.
    Hjorth L, Wiebe T, Karpman D (2002) Correct evaluation of renal glomerular filtration rate requires clearance assays. Pediatr Nephrol 17:847–851CrossRefGoogle Scholar

Copyright information

© IPNA 2006

Authors and Affiliations

  • John R. Brandt
    • 1
    • 2
    Email author
  • Craig S. Wong
    • 2
  • Jeffery D. Hanrahan
    • 2
  • Clifford Qualls
    • 3
  • Nancy McAfee
    • 4
  • Sandra L. Watkins
    • 4
  1. 1.UNMSOM Department of Pediatrics, Division of NephrologyUniversity of New MexicoAlbuquerqueUSA
  2. 2.Department of Pediatrics, Division of NephrologyUniversity of New MexicoAlbuquerqueUSA
  3. 3.Clinical Research CenterUniversity of New MexicoAlbuquerqueUSA
  4. 4.Department of PediatricsUniversity of WashingtonSeattleUSA

Personalised recommendations