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pediatric GFR

Hans Pottel, Laurence Dubourg, Karolien Goffin, Pierre Delanaye
The bedside Schwartz equation has long been and still is the recommended equation to estimate glomerular filtration rate (GFR) in children. However, this equation is probably best suited to estimate GFR in children with chronic kidney disease (reduced GFR) but is not optimal for children with GFR >75 mL/min/1.73 m2 . Moreover, the Schwartz equation requires the height of the child, information that is usually not available in the clinical laboratory. This makes automatic reporting of estimated glomerular filtration rate (eGFR) along with serum creatinine impossible...
January 2018: Advances in Chronic Kidney Disease
M S Ansari, Sandeep Kumar Nunia, Ankur Bansal, Prempal Singh, Virender Sekhon, Dharmveer Singh, Rahul Soni, Priyank Yadav
INTRODUCTION: Posterior urethral valve (PUV) is the most common cause of pediatric end stage renal disease (ESRD), imposing a major health burden on medical community caregivers and adversely affecting the quality of life of patients. Chronic kidney disease (CKD) stage III or estimated GFR of <60 mL/min/1.73 m2 is known to be associated with more adverse renal, cardiovascular, and clinical outcomes. Thus, it is desirable to identify factors predicting the rapid and early progression of disease...
November 22, 2017: Journal of Pediatric Urology
Kamal Kumar Goyal, Abhijeet Saha, Puneet Kaur Sahi, Manpreet Kaur, Nand Kishore Dubey, Parul Goyal, Ashish Dutt Upadhayay
BACKGROUND: Hepcidin is the main regulator of hepcidin-ferroportin axis and is elevated in children with chronic kidney disease (CKD). Anemia of CKD and its relation to hepcidin, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) in iron- and erythropoietin (EPO)-naïve, non-dialyzed children with CKD is under-studied. MATERIALS AND METHODS: This case-control study aimed to study the levels of hepcidin and other proinflammatory markers (IL-6, TNF-α, hs-CRP) and their relation with anemia in iron- and erythropoietin-naïve, non-dialysis CKD (stage 3 - 5) patients...
February 16, 2018: Clinical Nephrology
Tae Dong Jeong, Jaeryuk Kim, Woochang Lee, Sail Chun, Ki Sook Hong, Won Ki Min
The 1B equation is recommended for calculating the glomerular filtration rate (GFR) in children. Since few reports have evaluated the performance of the 1B equation, we investigated the performance of estimated GFR (eGFR) equations with the blood urea nitrogen (BUN) variable for pediatric cancer patients. In total, 203 children with cancer who underwent measured GFR (mGFR) assessment were enrolled. The median (range) mGFR and eGFR calculated using the updated Schwartz equation were 118 (43-241) and 135 (34-257) mL/min/1...
May 2018: Annals of Laboratory Medicine
Emil den Bakker, Reinoud J B J Gemke, Arend Bökenkamp
Although glomerular filtration rate (GFR) in children can be measured using a gold-standard technique following injection of an exogenous marker, this invasive and cumbersome technique is not widely available and GFR is commonly estimated using serum levels of endogenous markers. Creatinine, urea, cystatin C, beta-trace protein, and beta-2 microglobulin are well-established endogenous markers of kidney function. These markers differ in site of production and effects of diet and medication, as well as renal-tubular handling and extra-renal elimination...
February 1, 2018: Critical Reviews in Clinical Laboratory Sciences
Yoshimitsu Gotoh, Osamu Uemura, Kenji Ishikura, Tomoyuki Sakai, Yuko Hamasaki, Yoshinori Araki, Riku Hamda, Masataka Honda
BACKGROUND: The gold standard for evaluation of kidney function is renal inulin clearance (Cin). However, the methodology for Cin is complicated and difficult, especially for younger children and/or patients with bladder dysfunction. Therefore, we developed a simple and easier method for obtaining the estimated glomerular filtration rate (eGFR) using equations and values for several biomarkers, i.e., serum creatinine (Cr), serum cystatin C (cystC), serum beta-2 microglobulin (β2MG), and creatinine clearance (Ccr)...
January 25, 2018: Clinical and Experimental Nephrology
Kalathil K Sureshkumar, Amr Habbach, Amy Tang, Bhavna Chopra
BACKGROUND: Pediatric en bloc kidneys are considered marginal for transplantation into adults. We aimed to compare the long-term outcomes of pediatric en bloc vs. living donor kidney transplantation. METHODS: A retrospective review was undertaken on pediatric en bloc and living donor kidney transplants performed at our center between 1990 and 2001. The outcomes compared between the groups included 25 year graft survival and longitudinal glomerular filtration rate (GFR)...
January 18, 2018: Transplantation
Júlia Dauernheimer Machado, Eduardo Guimarães Camargo, Roberta Boff, Laís da Silva Rodrigues, Joíza Lins Camargo, Ariana Aguiar Soares, Sandra Pinho Silveiro
AIM: To evaluate the accuracy of creatinine and cystatin C (cysC) equations to estimate glomerular filtration rate (GFR) in type 2 diabetes mellitus (DM) patients and healthy adults. METHODS: Case-control study including 84 patients with type 2 DM and 100 healthy adults with measured GFR (mGFR)≥60mL/min/1.73m2. GFR was measured by 51Cr-EDTA and estimated (eGFR) by the following equations using creatinine, cysC or both markers: Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Caucasian Asian Pediatrics and Adults (CAPA), CKD-EPI creatinine-cystatin C (CKDEPI-CC), and CKD-EPI cystatin C (CKDEPIcysC)...
January 10, 2018: Clinical Biochemistry
Felipe Lozano-Kasten, Erick Sierra-Diaz, Alfredo de Jesus Celis-de la Rosa, María Margarita Soto Gutiérrez, Alejandro Aarón Peregrina Lucano
The occurrence of Chronic Kidney Disease (CKD) of unknown etiology in autochthonous child populations residing along the Lake Chapala lakeshore is endemic (Jalisco, México). The objective of this study was to determine the prevalence of albuminuria in the pediatric population and to measure the glomerular filtration rate in children with two positive albuminuria tests. Urinary albumin was measured in 394 children. Subjects with two or more positive albuminuria test donated blood samples for the determination of serum biomarkers...
December 14, 2017: International Journal of Environmental Research and Public Health
Guido Filler, Misan Lee
IMPORTANCE: Changes in kidney function are typically followed by the sequential estimation of glomerular filtration rate (eGFR). Formulae for eGFR work well on a population basis, but there are well-known conditions where they do not work. OBJECTIVE: The purpose of this review is to summarize the existing literature on special populations in the pediatric age range and provide recommendations on how to estimate GFR in these populations. FINDINGS: The reliability of creatinine depends on muscle mass, while cystatin C (not widely available) is limited by inflammation and changes in protein catabolism...
December 7, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ellen R Brooks, Shannon Haymond, Alfred Rademaker, Christopher Pierce, Irene Helenowski, Rod Passman, Faye Vicente, Bradley A Warady, Susan L Furth, Craig B Langman
BACKGROUND: In pediatric chronic kidney disease (pCKD), traditional factors (proteinuria, etiology, and race) do not fully explain disease progression. The levels of methylated arginine derivatives (MADs: asymmetric and symmetric dimethylarginine, respectively) rise in CKD and increase with CKD progression. The impact of MADs on glomerular filtration rate (GFR) decline has not been examined in pCKD. The aim of this study was to examine the additive impact of baseline (BL) levels of MADs on directly measured GFR (mGFR) decline per year (ml/min/1...
December 7, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Jing Tian, Ling Niu, Xinjiang An
One of the common factors for the premature death in children is advanced chronic kidney disease (CKD). Most often cardiovascular disease (CVD) is the reason for mortality. The cardiovascular (CV) morbidity starts early in the disease process and renal transplanted children (CKD-T) are also at risk. The present review is focused on the current views of the cardiovascular risks during CKD in pediatric patients. Variable data sources for the latest literature collection were explored which mainly included PubMed and Google Scholar...
November 2017: Experimental and Therapeutic Medicine
Yukihiko Kawasaki, Ryo Maeda, Syuto Kanno, Yuichi Suzuki, Shinichiro Ohara, Kazuhide Suyama, Mitsuaki Hosoya
BACKGROUND: To clarify the long-term efficacy of multiple-drugs combination therapy (PWDM) and tonsillectomy pulse therapy (TPT) for pediatric IgA nephropathy (IgAN), we retrospectively evaluated the clinical and laboratory findings as well as the prognosis for IgAN patients treated with each treatment at long-term follow-up. METHODS: We collected data on 61 children who had been diagnosed with severe IgAN. The children were retrospectively divided into two groups...
December 2, 2017: Clinical and Experimental Nephrology
Alice Monzani, Michela Perrone, Flavia Prodam, Stefania Moia, Giulia Genoni, Sara Testa, Fabio Paglialonga, Anna Rapa, Gianni Bona, Giovanni Montini, Alberto Edefonti
BACKGROUND: Impairment in orexigenic/anorexigenic hormone balance may be key in the pathogenesis of protein energy wasting in children with chronic kidney disease (CKD). Measurement of ghrelin and obestatin concentrations in children with CKD would help assess the potential contribution of these hormones to uremic protein energy wasting. METHODS: This was a cross-sectional case-control study. Acylated and unacylated ghrelin and obestatin were measured in 42 children on conservative treatment (CT), 20 children on hemodialysis, 48 pediatric renal transplant (RTx) recipients and 43 controls (CTR) (mean age 11...
November 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Elisa Ylinen, Laura Merras-Salmio, Riikka Gunnar, Timo Jahnukainen, Mikko P Pakarinen
OBJECTIVE: Although impaired renal function has been a frequent finding among adults with intestinal failure (IF), the data on children is scarce. The aim of this study was to assess renal function in pediatric-onset IF. METHODS: Medical records of 70 patients (38 boys) with pediatric-onset IF due to either short bowel syndrome (n = 59) or primary motility disorder (n = 11) and a history of parenteral nutrition (PN) dependency for ≥1 mo were evaluated. Renal function at the most recent follow-up was studied using plasma creatinine, cystatin C, and urea concentrations and estimated glomerular filtration rate (eGFR)...
January 2018: Nutrition
Stéphanie De Rechter, Justine Bacchetta, Nathalie Godefroid, Laurence Dubourg, Pierre Cochat, Julie Maquet, Ann Raes, Jean De Schepper, Pieter Vermeersch, Maria Van Dyck, Elena Levtchenko, Patrick D'Haese, Pieter Evenepoel, Djalila Mekahli
Context: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. Hypophosphatemia was demonstrated in adult patients with preserved renal function, together with high fibroblast growth factor 23 (FGF23) and low soluble Klotho levels. The latter explained the relative FGF23 hyporesponsiveness in this cohort. Objective: Evaluating phosphate and bone mineral metabolism in children with ADPKD compared with what is known in adult ADPKD patients...
November 1, 2017: Journal of Clinical Endocrinology and Metabolism
Nele K Kanzelmeyer, Britta Maecker-Kolhoff, Henriette Zierhut, Christian Lerch, Murielle Verboom, Dieter Haffner, Lars Pape
Data related to graft outcomes following post-transplant lymphoproliferative disease (PTLD) in pediatric kidney transplantation are scarce. Data were analyzed retrospectively from 12 children (eight boys) for 3 years after diagnosis of PTLD, with a loss of follow-up after 2 years in two of 12. In all cases, intensity of immunosuppressive therapy was reduced, which switched from calcineurin inhibitor to a mammalian target of rapamycin (mTOR) inhibitor in ten cases. Nine children were treated with six doses of rituximab according to the PED-PTLD-2005 protocol, with additional treatment in one child as per protocol...
September 14, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
Franz Schaefer, Howard Trachtman, Elke Wühl, Marietta Kirchner, Salim S Hayek, Ali Anarat, Ali Duzova, Sevgi Mir, Dusan Paripovic, Alev Yilmaz, Francesca Lugani, Klaus Arbeiter, Mieczyslaw Litwin, Jun Oh, Maria Chiara Matteucci, Jutta Gellermann, Simone Wygoda, Augustina Jankauskiene, Günter Klaus, Jiri Dusek, Sara Testa, Aleksandra Zurowska, Alberto Caldas Afonso, Melissa Tracy, Changli Wei, Sanja Sever, William Smoyer, Jochen Reiser
Importance: Conventional methods to diagnose and monitor chronic kidney disease (CKD) in children, such as creatinine level and cystatin C-derived estimated glomerular filtration rate (eGFR) and assessment of proteinuria in spot or timed urine samples, are of limited value in identifying patients at risk of progressive kidney function loss. Serum soluble urokinase receptor (suPAR) levels strongly predict incident CKD stage 3 in adults. Objective: To determine whether elevated suPAR levels are associated with renal disease progression in children with CKD...
November 6, 2017: JAMA Pediatrics
Omar Alkandari, Diane Hebert, Valerie Langlois, Lisa A Robinson, Rulan S Parekh
BackgroundAccurate monitoring of kidney function is important post-renal transplant; however, the routine use of measured glomerular filtration rate (GFR) or addition of newer serum markers is prohibitively expensive for routine clinical use, especially in children. We validated the modified Schwartz formula in pediatric renal transplant recipients across a range of demographic and clinical characteristics.MethodsIn a retrospective cohort study with nested cross-sectional analysis, we compared 505 measurements of estimated GFR using serum creatinine to simultaneous diethylenetriaminepentaacetic acid (DTPA) nuclear GFR (nGFR) measurements from 173 pediatric kidney transplant recipients who were < 18 years of age from 1 January 2001 to 31 December 2012 accounting for repeated measures...
December 2017: Pediatric Research
A Basiri, S Zare, N Simforoosh, A Tabibi, M H Shakibi
BACKGROUND: The shortage of cadaveric kidney donors has prompted transplant teams to expanding the donor selection criteria. The usage of pediatric cadaveric kidneys is one of those expanded criteria. But the main concern is the probability of hyperfiltration syndrome due to small renal mass of pediatric donors. OBJECTIVE: To compare the graft and patient survivals, post-transplantation complications, rate and severity of proteinuria secondary to hyperfiltration injury and the kidney growth of recipients who underwent transplantation from adult (group 1) and pediatric deceased donors (group 2)...
2017: International Journal of Organ Transplantation Medicine
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