A Simple Estimate of Glomerular Filtration Rate in Children Derived From Body Length and Plasma Creatinine

Schwartz, George J.; Haycock, G B; Edelmann, Chester M.; Spitzer, Adrian

doi:10.1542/peds.58.2.259

Cited by 2,058 publications

(133 citation statements)

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“…All blood samples and 24-h collected urine samples were obtained prior to the MRI exam, and creatinine levels in blood and urine were measured to calculate GFR. Below is the equation used to determine GFR, typically recorded in volume per time (e.g., mL/min) 23 : …”

Section: Methodsmentioning

confidence: 99%

Detection of impaired renal allograft function in paediatric and young adult patients using arterial spin labelling MRI (ASL-MRI)

Radović

Janković

Stevic

et al. 2022

Sci Rep

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The study aimed to discriminate renal allografts with impaired function by measuring cortical renal blood flow (cRBF) using magnetic resonance imaging arterial spin labelling (ASL-MRI) in paediatric and young adult patients. We included 18 subjects and performed ASL-MRI on 1.5 T MRI to calculate cRBF on parameter maps. cRBF was correlated to calculated glomerular filtration rate (GFR) and compared between patient groups with good (GFR ≥ 60 mL/min/1.73 m2) and impaired allograft function (GFR < 60 mL/min/1.73 m2). Mean cRBF in patients with good allograft function was significantly higher than in patients with impaired allograft function (219.89 ± 57.24 mL/min/100 g vs. 146.22 ± 41.84 mL/min/100 g, p < 0.008), showing a highly significant correlation with GFR in all subjects (r = 0.75, p < 0.0001). Also, the diffusion-weighted imaging (DWI-MRI) apparent diffusion coefficient (ADC) and Doppler measurements of peak-systolic and end-diastolic velocities and the resistive index (PS, ED, RI) were performed and both methods showed no significant difference between groups. ADC implied no correlation with GFR (r = 0.198, p = 0.464), while PS indicated moderate correlation to GFR (r = 0.48, p < 0.05), and PS and ED moderate correlation to cRBF (r = 0.58, p < 0.05, r = 0.56, p < 0.05, respectively). Cortical perfusion as non-invasively measured by ASL-MRI differs between patients with good and impaired allograft function and correlates significantly with its function.

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Section: Methodsmentioning

confidence: 99%

Detection of impaired renal allograft function in paediatric and young adult patients using arterial spin labelling MRI (ASL-MRI)

Radović

Janković

Stevic

et al. 2022

Sci Rep

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“…We assessed renal functions using the original Schwartz formula, which estimates creatinine clearance from serum creatinine levels in children ( 31 ). We defined ARC as a creatinine clearance value exceeding 160 mL/min/1.73 m 2 ( 23 , 32 ), and renal insufficiency as a clearance below 80 mL/min/1.73 m 2 ( 33 ), and we assumed normal renal function between those limits.…”

Section: Methodsmentioning

confidence: 99%

Ensuring Sufficient Trough Plasma Concentrations for Broad-Spectrum Beta-Lactam Antibiotics in Children With Malignancies: Beware of Augmented Renal Clearance!

et al. 2022

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Introduction: Broad-spectrum beta-lactams are commonly prescribed for empirical or selective treatment of bacterial infections in children with malignancies. In the immunocompromised, appropriate concentration exposure is crucial to ensure antimicrobial efficacy. Augmented renal clearance (ARC) is increasingly recognized in this population, and raises concern for unmet concentration targets. We conducted a retrospective evaluation of meropenem and piperacillin exposure in our hospital's pediatric hematology-oncology patients.Materials and Methods: We compared trough levels of meropenem and piperacillin in a cohort of unselected pediatric hematology-oncology patients stratified based on their estimated renal function as decreased, normal or with ARC, and on their neutrophil count.Results: Thirty-two children provided a total of 51 meropenem and 76 piperacillin samples. On standard intermittent intravenous regimen, 67% of all trough plasma concentrations were below targeted concentrations. In neutropenic children with bacterial infection, all meropenem and 60% of piperacillin levels were below target. Nearly two-thirds of total samples came from children with ARC. In these patients, antimicrobial exposure was insufficient in 85% of cases (compared to 36% in the decreased or normal renal function groups), despite a dosage sometimes exceeding the maximum recommended daily dose. Under continuous infusion of piperacillin, only 8% of plasma levels were insufficient.Discussion: Intermittent administration of meropenem and piperacillin often fails to ensure sufficient concentration exposure in children treated for malignancies, even at maximal recommended daily dosage. This can in part be attributed to ARC. We recommend thorough assessment of renal function, resolute dosage adjustment, continuous infusion whenever possible and systematic therapeutic drug monitoring.

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“…Date of birth, gender, weight, height, serum creatinine, haemoglobin, blood pressure, medications, cause of ESRD, type of dialysis therapy, donor type (live or cadaveric), and the time from KTx were extracted from the medical records. Estimated GFR (eGFR) was calculated using the original Schwartz formula (eGFR = k x height/serum creatinine) (24) as the Jaffe method was used for the measurement of creatinine. The Schwartz formula from 2009 was not fi tting suitably as it is recommended for an enzymatic measurement of creatinine.…”

Section: Measures Data and Data Collectionmentioning

confidence: 99%

Left ventricular hypertrophy in children and adolescents before and after kidney transplantation

Kolvek¹,

Podracká²

2022

BLL

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BACKGROUND: Left ventricular hypertrophy (LVH) is associated with a premature death in children with chronic kidney disease (CKD). We studied its change over time, related to a successful kidney transplantation (KTx) and assessed whether clinical variables were associated with the left ventricular mass index (LVMI). METHODS: We obtained the records of all children and adolescents, who were followed-up at the tertiary nephrology centre for children at the Children's University Hospital in Kosice, Slovakia, during 2008-2014, had completed echocardiographic studies while on chronic dialysis and had undergone a successful KTx, n=25. We assessed the longitudinally recorded left ventricular mass index (LVMI) and the presence/absence of LVH, and risk factors for LVH. RESULTS: The average prevalence of LVH was 23.5 % while on dialysis, and 29.4 % after KTx (p = 0.06). Pre-post changes per patient were relatively big. Uncontrolled systolic hypertension was signifi cantly related to LVMI (p=0.03). CONCLUSION: LVH is common after paediatric KTx and the reversibility of already present LVH seems to be rather problematic. Signifi cant changes of LVMI on the individual level suggest that modifi cation is feasible with a thorough control of (systolic) hypertension and of the other risk factors (Tab. 3, Fig. 1, Ref. 50).

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A Simple Estimate of Glomerular Filtration Rate in Children Derived From Body Length and Plasma Creatinine

Cited by 2,058 publications

References 0 publications

Detection of impaired renal allograft function in paediatric and young adult patients using arterial spin labelling MRI (ASL-MRI)

Detection of impaired renal allograft function in paediatric and young adult patients using arterial spin labelling MRI (ASL-MRI)

Ensuring Sufficient Trough Plasma Concentrations for Broad-Spectrum Beta-Lactam Antibiotics in Children With Malignancies: Beware of Augmented Renal Clearance!

Left ventricular hypertrophy in children and adolescents before and after kidney transplantation

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