Estimation of glomerular filtration rate from serum creatinine in children

Česká verzia

Authors: M. Fořtová ^1,2; B. Sopko ¹ ; F. Fencl ³; R. Kizek ¹; M. Kohutiar ¹; R. Průša ¹
Authors place of work: Ústav lékařské chemie a klinické biochemie 2. LF UK a FN Motol, Praha Přednosta: prof. MUDr. Richard Průša, CSc. ¹; Nemocnice Na Homolce, Praha Oddělení klinické biochemie, hematologie a imunologie Primář: doc. MUDr. Miroslav Průcha, Ph. D. ²; Pediatrická klinika 2. LF UK a FN Motol, Praha Přednosta: prof. MUDr. Zdeněk Šumník, Ph. D. ³
Published in the journal: Prakt. Lék. 2023; 103(4): 174-179
Category: Of different specialties

Summary

Aim: Comparison of methods for determination of serum creatinine (SCr) and evaluation of the effect of the used method on estimation of glomerular filtration rate (eGFR) in children with kidney disease.

Methods: We assessed SCr in 168 children (102 boys, age 1.7–15.9 years) by both, the Jaffe method and enzymatically. eGFR was estimated by Schwartz formula.

Results: The Jaffe method overestimated SCr at lower levels (< 200 μmol/L) but underestimated it at higher levels (> 250 μmol/L). Up to SCr of 60 μmol/L using Jaffe method, eGFR values were lower with higher SCr in comparison to enzymatic method as expected. However, eGFR values were paradoxically higher in all patients with SCr above 100 μmol/L using Jaffe method. This paradox was especially evident in adolescent boys mainly due to the different F coefficient used for eGFR calculation.

Conclusion: Estimation of GFR depends on the accuracy of the SCr measurement and the F coefficient in the Schwartz formula. These effects can have serious clinical consequences, especially in children with advanced chronic kidney disease stages 4 and 5, when the enzymatic method provides significantly lower eGFR values, which may result in earlier initiation of dialysis treatment.

Keywords:

Creatinine – Jaffe method – enzymatic method – Schwartz formula

Zdroje

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