Creatinine-based GFR-estimating equations in children with overweight and obesity

M.J.C.M. van Dam, H. Pottel, A.C.E. Vreugdenhil*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background With the increasing prevalence of childhood obesity and related development of chronic kidney disease (CKD), there is a critical need to understand how best to assess kidney function in children with obesity. Since serum creatinine (SCr) is recommended as marker of first choice for GFR estimation, we evaluated and compared creatinine-based GFR equations in children with overweight and obesity.Methods Six hundred children with overweight and obesity (53.5% female; mean age 12.20 +/- 3.28 years; mean BMI z-score 3.31 +/- 0.75) were included from the Centre for Overweight Adolescent and Children's Healthcare (COACH).Results Serum creatinine (SCr), normalized using Q-age polynomials obtained from reference values, results in median and mean SCr/Q value close to "1" for all age groups, and 96.5% of the children have a SCr/Q within the reference band [0.67-1.33], corresponding to the 2.5th and 97.5th percentile. eGFR CKiD (bedside Schwartz equation) and Schwartz-Lyon decreased with age, whereas eGFR EKFC and modified CKD-EPI40 showed no age-dependency, but the distribution of eGFR values was not symmetrical. eGFR CKiD under 25 (CKiDU25) demonstrated no age-dependency but major sex differences were observed. eGFR FAS age, FAS height, and adjusted-creatinine revised Lund-Malmo (LMR18) showed a relatively symmetrical distribution and no age-dependency.Conclusions Serum creatinine (SCr) values of children with overweight and obesity are mostly within the reference range for children. Normalization of SCr using reference Q-age polynomials works very well in this cohort. After evaluation of the different equations, we suggest that FAS age, FAS height, and LMR18 are the preferred creatinine-based GFR-estimating equations in children with overweight and obesity.
Original languageEnglish
Pages (from-to)2393-2403
Number of pages11
JournalPediatric Nephrology
Volume37
Issue number10
Early online date24 Feb 2022
DOIs
Publication statusPublished - Oct 2022

Keywords

  • Childhood obesity
  • Creatinine
  • eGFR
  • Pediatrics
  • GLOMERULAR-FILTRATION-RATE
  • BODY-SURFACE AREA
  • YOUNG-ADULTS
  • REFERENCE INTERVALS
  • KIDNEY-FUNCTION
  • SERUM
  • ADOLESCENTS
  • AGE
  • WEIGHT
  • VALUES

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