Estimation of the glomerular filtration rate in children and young adults by means of the CKD-EPI equation with age-adjusted creatinine values

Björk, Jonas; Nyman, Ulf; Larsson, Anders; Delanaye, Pierre; Pottel, Hans

doi:10.1016/j.kint.2020.10.017

Cited by 45 publications

(37 citation statements)

References 31 publications

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“…Categorization of oral PrEP preference into a binary variable likely contributed to lower uptake, as it also included those who ranked it second. The Cockroft–Gault formula may overestimate glomerular filtration rate (GFR) among young people [ 46 ], the CKD‐EPI formula is, therefore, preferred. However, follow‐up creatinine and GFR evaluation remained within baseline ranges showing that PrEP use remained safe.…”

Section: Discussionmentioning

confidence: 99%

Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

et al. 2022

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Introduction Oral pre‐exposure prophylaxis (PrEP) has been scaled up; however, data from real‐world settings are limited. We studied oral PrEP preference, uptake, adherence and continuation among adolescent girls and young women (AGYW) vulnerable to HIV in sub‐Saharan Africa. Methods We conducted a prospective cohort study among 14‐ to 24‐year‐old AGYW without HIV who were followed for 12 months in Kampala, Uganda. Within at least 14 days of enrolment, they received two education sessions, including demonstrations on five biomedical interventions that are; available (oral PrEP), will be available soon (long‐acting injectable PrEP and anti‐retroviral vaginal ring) and in development (PrEP implant and HIV vaccine). Information included mode and frequency of delivery, potential side effects and method availability. Volunteers ranked interventions, 1 = most preferred to 5 = least preferred. Oral PrEP was “preferred” if ranked among the top two choices. All were offered oral PrEP, and determinants of uptake assessed using Poisson regression with robust error variance. Adherence was assessed using plasma tenofovir levels and self‐reports. Results Between January and October 2019, 532 volunteers were screened; 285 enrolled of whom 265 received two education sessions. Mean age was 20 years (SD±2.2), 92.8% reported paid sex, 20.4% reported ≥10 sexual partners in the past 3 months, 38.5% used hormonal contraceptives, 26.9% had chlamydia, gonorrhoea and/or active syphilis. Of 265 volunteers, 47.6% preferred oral PrEP. Willingness to take PrEP was 90.2%; however, uptake was 30.6% ( n = 81). Following enrolment, 51.9% started PrEP on day 14 (same day PrEP offered), 20.9% within 30 days and 27.2% after 30 days. PrEP uptake was associated with more sexual partners in the past 3 months: 2–9 partners (aRR = 2.36, 95% CI: 1.20–4.63) and ≥10 partners (aRR 4.70, 95% CI 2.41–9.17); oral PrEP preference (aRR 1.53, 95% CI 1.08–2.19) and being separated (aRR 1.55, 95% CI 1.04–2.33). Of 100 samples from 49 volunteers during follow up, 19 had quantifiable tenofovir levels (>10 μg/L) of which only three were protective (>40 μg/L). Conclusions Half of AGYW preferred oral PrEP, uptake and adherence were low, uptake was associated with sexual behavioural risk and oral PrEP preference. Development of alternative biomedical products should be expedited to meet end‐user preferences and, community delivery promoted during restricted movement.

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Section: Discussionmentioning

confidence: 99%

Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

et al. 2022

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“…Demographics, clinical presentations at first visit to the participating centers, response to immunosuppressive agent, kidney biopsy information if performed, the last follow-up data, family history, parental consanguinity and genetic data were collected. The age-adjustment of serum creatinine concentrations based Chronic Kidney Disease Epidemiology Collaboration equation was used to estimate the glomerular filtration rate ( 19 ). When the patients were younger than 2 years, kidney dysfunction was defined as serum creatinine increasing >30% from the upper reference limits related to age and gender ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

The Clinical and Genetic Features in Chinese Children With Steroid-Resistant or Early-Onset Nephrotic Syndrome: A Multicenter Cohort Study

Zhu

Zhang

et al. 2022

Front. Med.

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Steroid-resistant nephrotic syndrome (SRNS) is one of the major causes of end-stage kidney disease (ESKD) in children and young adults. For approximately 30% of children with SRNS results from a genetic cause. In this study, genotype-phenotype correlations in a cohort of 283 pediatric patients with SRNS or early-onset NS (nephrotic syndrome presenting within the first year of life) from 23 major pediatric nephrology centers in China were analyzed. All patients were performed with next-generation sequencing and Sanger sequencing. The overall mutation detection rate was 37.5% (106 of 283 patients). WT1 was the most frequently detected mutation, followed by NPHS1, NPHS2, and ADCK4, and these four major causative genes (WT1, NPHS1, NPHS2, and ADCK4) account for 73.6% of patients with monogenic SRNS. Thirteen of 106 individuals (12.3%) carried mutations in ADCK4 that function within the coenzyme Q10 biosynthesis pathway. In the higher frequently ADCK4-related SRNS, two mutations, c.737G>A (p.S246N) and c.748G>C (p.D250H), were the most prevalent. Our study provides not only definitive diagnosis but also facilitate available targeted treatment for SRNS, and prediction of prognosis and renal outcome. Our indications for genetic testing are patients with FSGS, initial SRNS, cases of positive family history or those with extra-renal manifestations.

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“…Age − 0.00596 × 18 2 − Age 2 + 0.0000686 × 18 3 − Age 3 ; max(Age;18) represents the maximum of Age (actual age of the patient) and 18 years (the applied age threshold) CKD-EPI40 [28] 40) in males with Q ≤ 80 µmol/L, and…”

Section: Discussionmentioning

confidence: 99%

“…-Height-dependent full-age spectrum equation, referred to as FAS height [20]; -The new European Kidney Function Consortium (EKFC) equation, referred to as EKFC [23]; -Updated bedside Schwartz or CKiD equation [24]; -Schwartz-Lyon equation [25]; -CKiD under 25 years equation (CKiDU25) [26]; -Adjusted-creatinine revised Lund-Malmö equation, referred to as LMR18 [27]; -CKD-EPI equation with age-adjusted creatinine values, referred to as CKD-EPI40 [28]; -Improving renal complications in Adolescents with T2D through Research equation, referred to as iCARE [29].…”

Section: Creatinine-based Gfr-estimating Equationsmentioning

confidence: 99%

Creatinine-based GFR-estimating equations in children with overweight and obesity

2022

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Background With the increasing prevalence of childhood obesity and related development of chronic kidney disease (CKD), there is a critical need to understand how best to assess kidney function in children with obesity. Since serum creatinine (SCr) is recommended as marker of first choice for GFR estimation, we evaluated and compared creatinine-based GFR equations in children with overweight and obesity. Methods Six hundred children with overweight and obesity (53.5% female; mean age 12.20 ± 3.28 years; mean BMI z-score 3.31 ± 0.75) were included from the Centre for Overweight Adolescent and Children’s Healthcare (COACH). Results Serum creatinine (SCr), normalized using Q-age polynomials obtained from reference values, results in median and mean SCr/Q value close to “1” for all age groups, and 96.5% of the children have a SCr/Q within the reference band [0.67–1.33], corresponding to the 2.5th and 97.5th percentile. eGFR CKiD (bedside Schwartz equation) and Schwartz-Lyon decreased with age, whereas eGFR EKFC and modified CKD-EPI40 showed no age-dependency, but the distribution of eGFR values was not symmetrical. eGFR CKiD under 25 (CKiDU25) demonstrated no age-dependency but major sex differences were observed. eGFR FAS age, FAS height, and adjusted-creatinine revised Lund-Malmö (LMR18) showed a relatively symmetrical distribution and no age-dependency. Conclusions Serum creatinine (SCr) values of children with overweight and obesity are mostly within the reference range for children. Normalization of SCr using reference Q-age polynomials works very well in this cohort. After evaluation of the different equations, we suggest that FAS age, FAS height, and LMR18 are the preferred creatinine-based GFR-estimating equations in children with overweight and obesity. Clinical trial registration. ClinicalTrial.gov; Registration Number: NCT02091544. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

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Estimation of the glomerular filtration rate in children and young adults by means of the CKD-EPI equation with age-adjusted creatinine values

Cited by 45 publications

References 31 publications

Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

Oral pre‐exposure prophylaxis preference, uptake, adherence and continuation among adolescent girls and young women in Kampala, Uganda: a prospective cohort study

The Clinical and Genetic Features in Chinese Children With Steroid-Resistant or Early-Onset Nephrotic Syndrome: A Multicenter Cohort Study

Creatinine-based GFR-estimating equations in children with overweight and obesity

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