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Comparison of various methods of glomerular filtration rate measurements in children

Korean Journal of Pediatrics 2009;52(9):999-1004.
Published online September 15, 2009.
Comparison of various methods of glomerular filtration rate measurements in children
Na Mi Lee1, In Seok Lim2
1Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea
2Department of Pediatrics, College of Medicine, Chung-Ang University, Seoul, Korea
소아 환아에서 다양한 사구체 여과율 측정법의 비교
이나미1, 임인석2
1중앙대학교 의과대학 소아과학교실
2중앙대학교 의과대학 소아과학교실
Correspondence: 
In Seok Lim, Email: inseok@cau.ac.kr
Abstract
Purpose
Glomerular filtration rate (GFR) is a fundamental parameter in assessing renal function and predicting the progression of chronic renal disease. Because the use of serum creatinine has several disadvantages, many studies have investigated the use of cystatin C for estimating GFR. We compared creatinine clearance and GFR with formulas using serum creatinine and cystatin C.
Methods
We retrospectively analyzed 211 patients with various renal diseases and classified them into two groups according to creatinine clearance (Group 1: CrCl >90 mL/min/1.73m2, Group 2: CrCl <90 mL/min/1.73m2). We measured serum creatinine, cystatin C, and creatinine clearance. We calculated GFR using the Schwartz, Counahan, Filler and Lepage, Bokencamp et al, and Grubb et al formulas.
Results
GFR determined by the Schwartz formula had the highest correlation to creatinine clearance (r=0.415, P=0.00). GFR determined by various formulas using cystatin C had lower correlation to creatinine clearance (r=0.187, r=0.187, r= 0.291). The Schwartz and Counahan formulas showed greater diagnostic accuracy in detecting decreased GFR than cystatin C in group 2 (areas under the curve: Schwartz, 0.596; Counahan, 0.572; Filler, 0.512; Bokencamp, 0.508; and Grubb, 0.514).
Conclusion
GFR determined by the Schwartz and Counahan formulas using serum creatinine showed higher correlation coefficient than that determined by formulas using cystatin C. The formulas using cystatin C were not superior to those using serum creatinine in detecting decreased GFR. Cystatin C measurement was not satisfactory for assessing GFR in patients whose renal function was not severely decreased.
Key Words: Glomerular filtration rate, Cystatin C, Creatinine


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