Estimated glomerular filtration rate: applicability of creatinine-based equations in African children.

African children Enzymatic method Estimated glomerular filtration rate Serum creatinine

Journal

Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728

Informations de publication

Date de publication:
28 Mar 2024
Historique:
received: 28 11 2023
accepted: 05 03 2024
revised: 20 02 2024
medline: 28 3 2024
pubmed: 28 3 2024
entrez: 28 3 2024
Statut: aheadofprint

Résumé

The Schwartz equation is the most widely used serum creatinine (SCr)-based formula to estimate the glomerular filtration rate (GFR) in children of European descent, but whether this applies to African children is unclear. In a cross-sectional study, 513 apparently healthy African children aged 6 to 16 years were randomly recruited in school area of Kinshasa, the Democratic Republic of Congo (DRC). SCr was measured using calibrated enzymatic method. SCr was normalized using Q-values designed for European descent children, due to the absence of Q-values for African children. Commonly used eGFR equations were applied in this population. Normalization of SCr using Q-values for European descent children was effective in this cohort. The majority of African children (93.4%) have normalized SCr (SCr/Q) values within the reference interval (0.67-1.33) of children of European descent. The bedside-Schwartz equation was associated with significant age and sex dependency. However, the FAS-Age formula showed no sex and age dependency. The new CKiDU25 equation did not show a significant sex dependency. The recently introduced EKFC and LMR18 equations also showed no age and sex dependency, although the distribution of eGFR-values was not symmetrical. On the other hand, the FAS-Height and the Schwartz-Lyon equations showed significant sex dependency but no age dependency. The reference interval for SCr designed for European descent children can be applied to African children. Of all the equations studied, FAS-Age performed best and is most suitable because no height measurements are required. Establishment of specific Q-values for the widespread Jaffe-measured creatinine in Africa can further broaden applicability.

Sections du résumé

BACKGROUND BACKGROUND
The Schwartz equation is the most widely used serum creatinine (SCr)-based formula to estimate the glomerular filtration rate (GFR) in children of European descent, but whether this applies to African children is unclear.
METHODS METHODS
In a cross-sectional study, 513 apparently healthy African children aged 6 to 16 years were randomly recruited in school area of Kinshasa, the Democratic Republic of Congo (DRC). SCr was measured using calibrated enzymatic method. SCr was normalized using Q-values designed for European descent children, due to the absence of Q-values for African children. Commonly used eGFR equations were applied in this population.
RESULTS RESULTS
Normalization of SCr using Q-values for European descent children was effective in this cohort. The majority of African children (93.4%) have normalized SCr (SCr/Q) values within the reference interval (0.67-1.33) of children of European descent. The bedside-Schwartz equation was associated with significant age and sex dependency. However, the FAS-Age formula showed no sex and age dependency. The new CKiDU25 equation did not show a significant sex dependency. The recently introduced EKFC and LMR18 equations also showed no age and sex dependency, although the distribution of eGFR-values was not symmetrical. On the other hand, the FAS-Height and the Schwartz-Lyon equations showed significant sex dependency but no age dependency.
CONCLUSIONS CONCLUSIONS
The reference interval for SCr designed for European descent children can be applied to African children. Of all the equations studied, FAS-Age performed best and is most suitable because no height measurements are required. Establishment of specific Q-values for the widespread Jaffe-measured creatinine in Africa can further broaden applicability.

Identifiants

pubmed: 38546762
doi: 10.1007/s00467-024-06349-x
pii: 10.1007/s00467-024-06349-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : VLIRUOS
ID : Global Minds Scholarship of VLIR-UOS
Organisme : VLIRUOS
ID : DGD

Informations de copyright

© 2024. The Author(s), under exclusive licence to International Pediatric Nephrology Association.

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Auteurs

Agathe Bikupe Nkoy (AB)

Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo. agath.nkoy@gmail.com.
Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium. agath.nkoy@gmail.com.

Therance Tobo Matoka (TT)

Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

Justine Busanga Bukabau (JB)

Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

Ernest Kiswaya Sumaili (EK)

Division of Nephrology, Department of Internal Medicine, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

Veerle Labarque (V)

Department of Pediatric Hematology, University Hospital Leuven, Leuven, Belgium.
Center for Molecular and Vascular Biology, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.

Lambertus P van den Heuvel (LP)

Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Department of Pediatric Nephrology, Radboud University Medical Centre, Nijmegen, Netherlands.

Elena Levtchenko (E)

Laboratory of Pediatric Nephrology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Department of Pediatric Nephrology, Amsterdam University Medical Centre, Amsterdam, The Netherlands.

Etienne Cavalier (E)

Division of Clinical Chemistry, CHU Sart Tilman, University of Liège, Liège, Belgium.

Pierre Delanaye (P)

Department of Nephrology, Dialysis, Hypertension and Transplantation, CHU Sart Tilman, University of Liège , Liège, Belgium.
Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France.

Pépé Mfutu Ekulu (PM)

Division of Nephrology, Department of Pediatrics, University Hospital of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

Hans Pottel (H)

Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium.

Classifications MeSH