Estimating and measuring glomerular filtration rate in children
- 1 May 2008
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Nephrology and Hypertension
- Vol. 17 (3), 320-325
- https://doi.org/10.1097/mnh.0b013e3282fb77f2
Abstract
Glomerular filtration rate is the best determinant of kidney function in children. A decline in glomerular filtration rate may be the only sign of renal disease. A knowledge of glomerular filtration rate allows the clinician to appropriately dose medications, administer fluids, and intervene early to prevent end-stage renal failure. The aim of this review is to discuss the current options for determining glomerular filtration rate in children and the latest advances in research on this topic. Owing to the limited availability of inulin, the gold standard for measuring glomerular filtration rate, and the concern for using radioactivity, the plasma disappearance of iohexol has been utilized to measure glomerular filtration rate in children, and this represents a practical option for glomerular filtration rate determination in both clinical and research studies. By contrast, creatinine-based estimates of glomerular filtration rate (e.g. Schwartz formula) are more practical for bedside use. To improve their precision, recent formulas have incorporated the use of additional endogenous markers, such as cystatin C, albumin, and blood urea nitrogen. Iohexol plasma clearances should be used to accurately measure glomerular filtration rate in children. New estimating equations with multiple endogenous markers are being developed for everyday clinical use. However, at present, there is no substitute for an accurate glomerular filtration rate determination, particularly in children with conditions affecting muscle mass or body habitus.Keywords
This publication has 34 references indexed in Scilit:
- A Practical Method of Measuring Glomerular Filtration Rate by Iohexol Clearance Using Dried Capillary Blood SpotsNephron Clinical Practice, 2007
- Glomerular filtration rate measurement and estimation in chronic kidney diseasePediatric Nephrology, 2007
- GFR is better estimated by considering both serum cystatin C and creatinine levelsPediatric Nephrology, 2006
- Development of an outpatient finger-prick glomerular filtration rate procedure suitable for epidemiological studiesKidney International, 2006
- Estimating Pediatric Glomerular Filtration Rates in the Era of Chronic Kidney Disease StagingJournal of the American Society of Nephrology, 2006
- Timed-urine collections for renal clearance studiesPediatric Nephrology, 2005
- The Cockcroft-Gault formula should not be used in childrenKidney International, 2005
- Predicting GFR in children and adults: A comparison of the Cockcroft-Gault, Schwartz, and Modification of Diet in Renal Disease formulasKidney International, 2003
- Plasma creatinine and urea concentration in children: Normal values for age and sexThe Journal of Pediatrics, 1976
- The congruence of creatinine and inulin clearances in children: Use of the Technicon Auto AnalyzerThe Journal of Pediatrics, 1972