Plasma creatinine and urea concentration in children: Normal values for age and sex

Schwartz, George J.; Haycock, G B; Chir, B.; Spitzer, Adrian

doi:10.1016/s0022-3476(76)81125-0

Cited by 203 publications

(97 citation statements)

References 3 publications

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“…Renal function was either normal (normal plasma creatinine for age and gender, n = 18), mildly reduced (plasma creatinine increased but less than 177 mol/l; n = 12) or moderately reduced (plasma creatinine ranging between 178 and 354 mol/l, n = 5). 13 Eight patients were on regular dialysis (haemodialysis, n = 3; home peritoneal dialysis, n = Journal of Human Hypertension 5). In the 43 patients sitting arterial pressure was persistently above the centile 95 for body length and gender.…”

Section: Methodsmentioning

confidence: 99%

Antihypertensive efficacy of amlodipine in children with chronic kidney diseases

et al. 2001

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In adults the calcium antagonist amlodipine given once a day has proved to be an attractive addition to the antihypertensive armamentarium. The present report describes our experience in 43 paediatric outpatients (26 boys and 17 girls, aged between 1.1 and 19, median 9.8 years) with chronic kidney diseases. The patients were given amlodipine for 16 weeks as part of their antihypertensive treatment. Before amlodipine arterial pressure was 150 (142-163)/90 (84 -95) mm Hg (median and interquartile range). Six patients withdrew from amlodipine because of oedema, flushing or headache. In the remaining patients amlodipine 7.7 (6.9-9.4) mg/m 2 body surface area once a day significantly decreased arterial pressure by 17 (13-22)/10 (7-13) mm Hg. The

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Section: Methodsmentioning

confidence: 99%

Antihypertensive efficacy of amlodipine in children with chronic kidney diseases

et al. 2001

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“…The more recent enzymatic creatinine method results in lower determinations compared with the older Jaffe method, even when the latter was improved with a dialysis step and elimination of interfering samples. 18 A more accurate estimate of GFR was crucial to the goals of the CKiD study, because iGFR was measured only biennially after the first two visits; therefore, an accurate assessment of GFR is needed during the annual study visits when iGFR is not measured.…”

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confidence: 99%

New Equations to Estimate GFR in Children with CKD

Schwartz

Muñoz

Schneider

et al. 2009

Journal of the American Society of Nephrology

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The Schwartz formula was devised in the mid-1970s to estimate GFR in children. Recent data suggest that this formula currently overestimates GFR as measured by plasma disappearance of iohexol, likely a result of a change in methods used to measure creatinine. Here, we developed equations to estimate GFR using data from the baseline visits of 349 children (aged 1 to 16 yr) in the Chronic Kidney Disease in Children (CKiD) cohort. Median iohexol-GFR (iGFR) was 41.3 ml/min per 1.73 m 2 (interquartile range 32.0 to 51.7), and median serum creatinine was 1.3 mg/dl. We performed linear regression analyses assessing precision, goodness of fit, and accuracy to develop improvements in the GFR estimating formula, which was based on height, serum creatinine, cystatin C, blood urea nitrogen, and gender. This formula yielded 87.7% of estimated GFR within 30% of the iGFR, and 45.6% within 10%. In a test set of 168 CKiD patients at 1 yr of follow-up, this formula compared favorably with previously published estimating equations for children. Furthermore, with height measured in cm, a bedside calculation of 0.413*(height/serum creatinine), provides a good approximation to the estimated GFR formula. Additional studies of children with higher GFR are needed to validate these formulas for use in screening all children for CKD.

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“…Cumulative incidences of persistent leukocyturia and serum creatinine Ͼ50% above age-and sex-specific normal values 23 were calculated with Kaplan-Meier analysis. The influences of pharmacokinetic factors were determined with the log rank test.…”

Section: Discussionmentioning

confidence: 99%

Persistent Sterile Leukocyturia Is Associated With Impaired Renal Function in Human Immunodeficiency Virus Type 1-Infected Children Treated With Indinavir

Rossum¹,

Dieleman

Fraaij³

et al. 2002

Pediatrics

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ABSTRACT. Background. Prolonged administration of indinavir is associated with the occurrence of a variety of renal complications in adults. These well-documented side effects have restricted the use of this potent protease inhibitor in children.Design. A prospective study to monitor indinavir-related nephrotoxicity in a cohort of 30 human immunodeficiency virus type 1-infected children treated with indinavir.Methods. Urinary pH, albumin, creatinine, the presence of erythrocytes, leukocytes, bacteria and crystals, and culture were analyzed every 3 months for 96 weeks. Serum creatinine levels were routinely determined at the same time points. Steady-state pharmacokinetics of indinavir were done at week 4 after the initiation of indinavir.Results. The cumulative incidence of persistent sterile leukocyturia (>75 cells/L in at least 2 consecutive visits) after 96 weeks was 53%. Persistent sterile leukocyturia was frequently associated with a mild increase in the urine albumin/creatinine ratio and by microscopic hematuria. The cumulative incidence of serum creatinine levels >50% above normal was 33% after 96 weeks. Children with persistent sterile leukocyturia more frequently had serum creatinine levels of 50% above normal than those children without persistent sterile leukocyturia. In children younger than 5.6 years, persistent sterile leukocyturia was significantly more frequent than in older children. A higher cumulative incidence of persistent leukocyturia was found in children with an area under the curve >19 mg/L*h or a peak serum level of indinavir >12 mg/L. In 4 children, indinavir was discontinued because of nephrotoxicity. Subsequently, the serum creatinine levels decreased, the urine albumin/creatinine ratios returned to zero, and the leukocyturia disappeared within 3 months.Conclusions. Children treated with indinavir have a high cumulative incidence of persistent sterile leukocyturia. Children with persistent sterile leukocyturia more frequently had an increase in serum creatinine levels of >50% above normal. Younger children have an additional risk for renal complications. The impairment of the renal function in these children occurred in the absence of clinical symptoms of nephrolithiasis. Indinavirassociated nephrotoxicity must be monitored closely, especially in children with risk factors such as persistent sterile leukocyturia, age <5.6 years, an area under the curve of indinavir >19 mg/L*h, and a C max >12 mg/L. Pediatrics 2002;110(2). URL: http://www.pediatrics.org/ cgi/content/full/110/2/e19; human immunodeficiency virus, children, indinavir, nephrotoxicity.ABBREVIATIONS. HIV, human immunodeficiency virus; AUC, area under plasma-concentration curve; IQR, interquartile range. I ndinavir is a potent human immunodeficiency virus (HIV)-protease inhibitor that has been used successfully in adults in combination with nucleoside reverse transcriptase inhibitors to suppress infections by HIV-1. Discontinuation of the antiretroviral therapy rapidly results in virologic rebound, decreased immune function, ...

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Plasma creatinine and urea concentration in children: Normal values for age and sex

Cited by 203 publications

References 3 publications

Antihypertensive efficacy of amlodipine in children with chronic kidney diseases

Antihypertensive efficacy of amlodipine in children with chronic kidney diseases

New Equations to Estimate GFR in Children with CKD

Persistent Sterile Leukocyturia Is Associated With Impaired Renal Function in Human Immunodeficiency Virus Type 1-Infected Children Treated With Indinavir

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