Reliability of glomerular filtration rate estimating formulas compared to iohexol plasma clearance in critically ill children.
Acute kidney injury
Augmented renal clearance
Betatrace protein
Creatinine
Cystatin C
Intensive care
Pediatrics
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
15
02
2022
accepted:
18
07
2022
revised:
14
07
2022
pubmed:
3
9
2022
medline:
12
10
2022
entrez:
2
9
2022
Statut:
ppublish
Résumé
Accurate renal function assessment is crucial to guide intensive care decision-making and drug dosing. Estimates of glomerular filtration rate (eGFR) are routinely used in critically ill children; however, these formulas were never evaluated against measured GFR (mGFR) in this population. We aimed to assess the reliability of common eGFR formulas compared to iohexol plasma clearance (CL In this proof-of-concept study, eGFR formulas were found to be largely inaccurate in the PICU population. Clinicians should therefore use these formulas with caution to guide drug dosing and therapeutic interventions in critically ill children. More research in subgroup populations is warranted to conclude on generalizability of these study findings. gov NCT05179564, registered retrospectively on January 5, 2022. • Both acute kidney injury and augmented renal clearance may be present in PICU patients and warrant adaptation of therapy, including drug dosing. • Biomarker-based eGFR formulas are widely used for GFR assessment in critically ill children, although endogenous filtration biomarkers have important limitations in PICU patients and eGFR formulas have never been validated against measured GFR in this population. • eGFR formulas were found to be largely inaccurate in the PICU population when compared to measured GFR by iohexol clearance. Clinicians should therefore use these formulas with caution to guide drug dosing and therapeutic interventions in critically ill children. • Iohexol plasma clearance could be considered an alternative for accurate GFR assessment in PICU patients.
Identifiants
pubmed: 36053381
doi: 10.1007/s00431-022-04570-0
pii: 10.1007/s00431-022-04570-0
doi:
Substances chimiques
Biomarkers
0
Iohexol
4419T9MX03
Creatinine
AYI8EX34EU
Banques de données
ClinicalTrials.gov
['NCT05179564']
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3851-3866Subventions
Organisme : Trasher Research Fund
ID : 15174
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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