First published online: 19 Jun 2016
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J Renal Inj Prev. 2016;5(3).
doi: 10.15171/jrip.2016.33
PMID: 27689114
PMCID: PMC5040004
  Abstract View: 762
  PDF Download: 441

Original Article

Correlation between cystatin C-based formulas, Schwartz formula and urinary creatinine clearance for glomerular filtration rate estimation in children with kidney disease
 

Afshin Safaei-Asl 1 * , Mercede Enshaei 1, Abtin Heydarzadeh 2, Shohreh Maleknejad 1

1 Department of Pediatrics, Guilan University of Medical Sciences, Guilan, Iran
2 Department of Community Medicine, Guilan University of Medical Sciences, Guilan, Iran
*Corresponding author: Afshin Safaei-Asl, Email: afshin_safaei2@yahoo.com, Email: afshin-safaei@gums.ac.ir

Article

Introduction: Assessment of glomerular filtration rate (GFR) is an important tool for monitoring renal function.

Objectives: Regarding to limitations in available methods, we intended to calculate GFR by cystatin C (Cys C) based formulas and determine correlation rate of them with current methods.

Patients and Methods: We studied 72 children (38 boys and 34 girls) with renal disorders. The 24 hour urinary creatinine (Cr) clearance was the gold standard method. GFR was measured with Schwartz formula and Cys C-based formulas (Grubb, Hoek, Larsson and Simple). Then correlation rates of these formulas were determined.

Results: Using Pearson correlation coefficient, a significant positive correlation between all formulas and the standard method was seen (R2 for Schwartz, Hoek, Larsson, Grubb and Simple formula was 0.639, 0.722, 0.705, 0.712, 0.722, respectively) (P<0.001). Cys C-based formulas could predict the variance of standard method results with high power. These formulas had correlation with Schwarz formula by R2 0.62-0.65 (intermediate correlation). Using linear regression and constant (y-intercept), it revealed that Larsson, Hoek and Grubb formulas can estimate GFR amounts with no statistical difference compared with standard method; but Schwartz and Simple formulas overestimate GFR.

Conclusion: This study shows that Cys C–based formulas have strong relationship with 24 hour urinary Cr clearance. Hence, they can determine GFR in children with kidney injury, easier and with enough accuracy. It helps the physician to diagnosis of renal disease in early stages and improves the prognosis.

Implication for health policy/practice/research/medical education:

Glomerular filtration rate (GFR) is a calculation that determines how well the blood is filtered by the kidneys, which is one way to measure remaining kidney function. Assessment of GFR is an important tool for monitoring renal function. GFR is best measured by injecting compounds such as inulin, chromium-EDTA or iohexol, however these techniques are complicated, costly, time-consuming and have potential side-effects. Cystatin C is cysteine proteases inhibitor and has a low molecular weight that freely filters across the glomerulus and is neither reabsorbed nor metabolized by the kidney. Regarding to limitations in available methods, in this study we intended to calculate GFR by cystatin C based formulas and determine correlation rate of them with current methods.

Please cite this paper as: Safaei-Asl A, Enshaei M, Heydarzadeh A, Maleknejad S. Correlation between cystatin C-based formulas, Schwartz formula and urinary creatinine clearance for glomerular filtration rate estimation in children with kidney disease. J Renal Inj Prev. 2016;5(3):157-161. DOI: 10.15171/jrip.2016.33

 
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