Predicting GFR in children and adults: A comparison of the Cockcroft-Gault, Schwartz, and Modification of Diet in Renal Disease formulas

Pierrat, Annick; Gravier, Elisabeth; Saunders, C; Caira, Marie-Véronique; Ait-Djafer, Z.; Legras, Bernard; Mallié, Jean-Pierre

doi:10.1046/j.1523-1755.2003.00208.x

Cited by 145 publications

(114 citation statements)

References 37 publications

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“…When all three variables were incorporated into a genderbased equation with an added coefficient for height alone (model III), there was further improvement in root mean square error (0.176) and R 2 (75.2%), and 88 and 46% of the estimates fell within 30 and 10%, respectively, of iGFR values, which is quite comparable to the best equations developed for adults; however, previous studies showed that the adult GFR estimating formulas derived from Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) are not useful for children. 26 Two recent studies estimated GFR in children with higher GFR using equations including both Scr and cystatin C. 20,21 We subjected the CKiD data to the models reported by Bouvet et al 20 and Zappitelli et al 21 Whereas these equations with their published coefficients did not perform optimally in our test data set, after correction of their coefficients to the CKiD data, their precision and accuracy were only slightly lower than our model III formula (Table 5). We cannot explain why their original equations did not perform well in our test data set, but differences in GFR level and methods of measuring GFR, cystatin C, and creatinine probably necessitated correcting their coefficients to the CKiD data to optimize performance.…”

Section: Discussionmentioning

confidence: 99%

New Equations to Estimate GFR in Children with CKD

Schwartz

Muñoz

Schneider

et al. 2009

Journal of the American Society of Nephrology

3,106

2,267

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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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Section: Discussionmentioning

confidence: 99%

New Equations to Estimate GFR in Children with CKD

Schwartz

Muñoz

Schneider

et al. 2009

Journal of the American Society of Nephrology

3,106

2,267

View full text Add to dashboard Cite

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“…The Cockroft-Gault formula was used to compute GFR in subjects 12 years of age and older [21,22]. This equation incorporates age, sex, height, weight, and serum creatinine levels into its estimation of GFR.…”

Section: Phenotype Definitionmentioning

confidence: 99%

Estimated glomerular filtration rate in sickle cell anemia is associated with polymorphisms of bone morphogenetic protein receptor 1B

Nolan

Cohen

et al. 2006

American J Hematol

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Renal disease is common in sickle cell anemia. In this exploratory work, we used data from a longitudinal study of the natural history of sickle cell disease to examine the hypothesis that polymorphisms (SNPs) in selected candidate genes are associated with glomerular filtration rate (GFR). DNA samples and clinical and laboratory data were available for 1,140 patients with sickle cell anemia. GFR was estimated using the Cockcroft-Gault and Schwartz formulas for adults and children, respectively. We examined *175 haplotype tagging (ht) SNPs in about 70 genes of the TGFb/BMP pathway for their association with GFR using linear regression. Four SNPs in BMPR1B, a bone morphogenetic protein (BMP) receptor gene, yielded statistically significant associations (P values ranging from 0.015 to 0.046). Three haplotypes in this gene were also associated with GFR. The TGF-b/BMP pathway has been associated with the development of diabetic nephropathy, which has some features in common with sickle cell nephropathy. Our results suggest that, as with other subphenotypes of sickle cell disease, renal function may be genetically modulated. Am. J. Hematol. 82:179-184, 2007. V V C 2006 Wiley-Liss, Inc.

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“…The Cockcroft-Gault equation [33], which is used to estimate GFR in adults, may also be useful in children over 12 years of age [34].…”

Section: Estimated Gfr Based On Serum Creatininementioning

confidence: 99%

“…Whereas there is good overall agreement with standard inulin clearances in children aged 12 years and older, Cockcroft-Gault estimates are very different from inulin clearances in younger patients. The formula for adults, generated by the Modification of Diet in Renal Disease (MDRD) group, is not useful in children [34].…”

Section: Estimated Gfr Based On Serum Creatininementioning

confidence: 99%

Glomerular filtration rate measurement and estimation in chronic kidney disease

2007

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Glomerular filtration rate (GFR) assesses kidney function. GFR is measured by renal clearance techniques; inulin clearance is the gold standard but is not easily measured. Thus, other methods to determine GFR have been utilized. Endogenous creatinine clearance (CrCl) is the most widely used, but creatinine secretion falsely elevates GFR. Cimetidine inhibits creatinine secretion, such that CrCl equals GFR, provided there are no difficulties with bladder emptying. Estimation of GFR from serum creatinine (e.g. Schwartz formula) is useful clinically; however, such formulae have not been updated for enzymatic creatinine autoanalyzers. Cystatin C, a small protein, is produced at a relatively constant rate and is reabsorbed in the proximal tubule. Cystatin C may be more sensitive than creatinine in detecting a reduction in GFR, but further studies are needed to prove this. Single injection (plasma) clearance techniques are the most precise measures of GFR. Iohexol is an exogenous marker that is comparable to inulin and 51 Cr-EDTA and can be measured by high-performance liquid chromatography (HPLC). Our pilot and the Chronic Kidney Disease in Children (CKiD) North American studies show that iohexol can accurately measure GFR using a four-point plasma disappearance curve national studies show that iohexol can accurately measure GFR using a four-point plasma disappearance curve (10, 30, 120, and 300 min) or, in most cases, a two-point disappearance time (120 and 300 min).

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Predicting GFR in children and adults: A comparison of the Cockcroft-Gault, Schwartz, and Modification of Diet in Renal Disease formulas

Cited by 145 publications

References 37 publications

New Equations to Estimate GFR in Children with CKD

New Equations to Estimate GFR in Children with CKD

Estimated glomerular filtration rate in sickle cell anemia is associated with polymorphisms of bone morphogenetic protein receptor 1B

Glomerular filtration rate measurement and estimation in chronic kidney disease

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