Inaccuracy of the Schwartz formula in estimating glomerular filtration rate in Nigerian children

Background: Kidney disease is more common in people of African descent in developed countries. Studies reporting estimate Glomerular Filtration Rate (eGFR) in African populations and people living with HIV have been carried more frequently on adults than children. The study aimed to assess eGFR by use of the SCHWARTZ formula in HIV infected children seen at tertiary hospital.Methods: A descriptive, prospective and cross sectional study of 221 children with HIV infection. Schwartz formula was used to determine eGFR. The main outcome measures were eGFR. The study population comprised HIV infected children attending Paediatric out-patients’ clinic and those admitted into the Paediatric wards, aged between 6 months and 15 years. Data was analysed using SPSS version 20 and results presented in tables and figures. Results: The age range of the study subjects was 12 months to 15 years with the mean age and SD of 8.21±3.61 years. There were 129 (58.4%) male and 92 (41.6%) female children with male to female ratio 1: 0.7. The mean age for males was 7.87±3.49 years while that for females was 8.70±3.71 years. The eGFR for the study as determined by Schwartz formula had a range of 49.21 to 463.67 ml/ min/ 1.73m2 with the mean of 159.56±59.04 ml/min. The mean eGFR for the males and females were 166.39±63.54ml/ min and 149.99±45.01 ml/ min respectively. Conclusion: The study, in comparison with other studies, observed a lower prevalence of CKD in HIV infected children. Detection of CKD in HIV infection children may be more optimal if combined methods are employed.

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Estimation of GFR in Patients With Cystic Fibrosis: A Cross-Sectional Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358119899312 ◽

2020 ◽

Vol 7 ◽

pp. 205435811989931 ◽

Cited By ~ 1

Author(s):

Andrea Wallace ◽

April Price ◽

Erin Fleischer ◽

Michael Khoury ◽

Guido Filler

Keyword(s):

Cystic Fibrosis ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Correlation Coefficient ◽

Filtration Rate ◽

Pediatric Patients ◽

Cross Sectional Study ◽

Infectious Complications ◽

Schwartz Formula ◽

Cross Sectional

Background: Patients with cystic fibrosis (CF) have frequent infectious complications requiring nephrotoxic medications, necessitating monitoring of renal function. Although adult studies have suggested that cystatin C (CysC)-based estimated glomerular filtration rate (eGFR) may be preferable due to reduced muscle mass of patients with CF, pediatric patients remain understudied. Objective: Our objective was to determine which eGFR formula is best for estimating glomerular filtration rate (GFR) in pediatric patients with CF. Methods: A total of 17 patients with CF treated with nephrotoxic antibiotics were recruited from the Children’s Hospital at London Health Sciences Centre, London, Ontario, Canada. 99Tc DTPA GFR (measured GFR [mGFR]) was measured with 4-point measurements starting at 120 minutes using a 2-compartmental model with Brøchner-Mortensen correction, with simultaneous measurement of creatinine, urea, and CysC. The eGFR was calculated using 16 known equations based on creatinine, urea, CysC, or combinations of these. Primary outcome measures were correlation with mGFR, and agreement within 10% for various eGFR equations. Results: Mean mGFR was 136 ± 21 mL/min/1.73 m2. Mean creatinine, CysC, and urea were 38 ± 10 μmol/L, 0.72 ± 0.08 mg/L, and 3.9 ± 1.4 mmol/L, respectively. The 2014 Grubb CysC eGFR had the best correlation coefficient ( r = 0.75, P = .0004); however, only 35% were within 10%. The new Schwartz formula with creatinine and urea had the best agreement within 10%, but a relatively low correlation coefficient ( r = 0.63, P = .0065, 64% within 10%). Conclusions: Our study suggests that none of the eGFR formulae work well in this small cohort of pediatric patients with CF with preserved body composition, possibly due to inflammation causing false elevations of CysC. Based on the small numbers, we cannot conclude which eGFR formula is best.

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KIDNEY FUNCTION IN NEWBORN CHILDREN

EurasianUnionScientists ◽

10.31618/10.31618/esu.2413-9335.2020.5.76.932 ◽

2020 ◽

Vol 5 (7(76)) ◽

pp. 54-59

Author(s):

T.N, Ugleva ◽

L.A. Alexeenko

Keyword(s):

Glomerular Filtration Rate ◽

Serum Creatinine ◽

Glomerular Filtration ◽

Kidney Function ◽

Filtration Rate ◽

Elevated Serum ◽

Extremely Low Birth Weight ◽

Postnatal Life ◽

Schwartz Formula ◽

Premature Babies

Objective. The article discusses the problem of assessing renal function of the kidneys in premature babies born as a result of prematurely premature births with extremely low birth weight. Materials and methods. The functional state of the kidneys was evaluated in 148 children with ELBW and VLBW in the period from 1 to 90 days of postnatal age. The urine output rate, serum creatinine level, GFR calculation according to the Schwartz formula. Results. The results of the study showed that premature babies with ELBW are characterized by elevated serum creatinine levels and a low glomerular filtration rate, starting from the 4th day of life. An increase in GFR from the 3rd week of postnatal life significantly increases the likelihood of survival of premature babies with ELBW. The decrease in glomerular filtration rate in this contingent of children is associated not so much with kidney damage, but rather due to a more pronounced immaturity of nephrons Conclusion: Kidney function in preterm infants with ENMT is much lower than even in more mature children with ONHT. This is confirmed by high persistent levels of creatinine in serum and low SCF values throughout the neonatal period of life.

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Long-term renal outcome in methylmalonic acidemia in adolescents and adults

Orphanet Journal of Rare Diseases ◽

10.1186/s13023-021-01851-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Myriam Dao ◽

Jean-Baptiste Arnoux ◽

Frank Bienaimé ◽

Anaïs Brassier ◽

François Brazier ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Methylmalonic Acidemia ◽

Renal Outcome ◽

Schwartz Formula ◽

Glomerular Proteinuria ◽

Therapeutic Decisions ◽

Proximal Tubular

Abstract Background Chronic kidney disease (CKD) is one of the main long-term prognosis factors in methylmalonic acidemia (MMA), a rare disease of propionate catabolism. Our objective was to precisely address the clinical and biological characteristics of long-term CKD in MMA adolescent and adult patients. Patients and methods In this retrospective study, we included MMA patients older than 13 years who had not received kidney and/or liver transplantation. We explored tubular functions, with special attention to proximal tubular function. We measured glomerular filtration rate (mGFR) by iohexol clearance and compared it to estimated glomerular filtration rate (eGFR) by Schwartz formula and CKD-EPI. Results Thirteen patients were included (M/F = 5/8). Median age was 24 years (13 to 32). Median mGFR was 57 mL/min/1.73 m2 (23.3 to 105 mL/min/1.73 m2). Ten out of 13 patients had mGFR below 90 mL/min/1.73 m2. No patient had significant glomerular proteinuria. No patient had complete Fanconi syndrome. Only one patient had biological signs suggestive of incomplete proximal tubulopathy. Four out of 13 patients had isolated potassium loss, related to a non-reabsorbable anion effect of urinary methylmalonate. Both Schwartz formula and CKD-EPI significantly overestimated GFR. Bias were respectively 16 ± 15 mL/min/1.73 m2 and 37 ± 22 mL/min/1.73 m2. Conclusion CKD is a common complication of the MMA. Usual equations overestimate GFR. Therefore, mGFR should be performed to inform therapeutic decisions such as dialysis and/or transplantation. Mild evidence of proximal tubular dysfunction was found in only one patient, suggesting that other mechanisms are involved.

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Comparison of the glomerular filtration rate in children by the new revised Schwartz formula and a new generalized formula

Kidney International ◽

10.1038/ki.2012.388 ◽

2013 ◽

Vol 83 (3) ◽

pp. 524-530 ◽

Cited By ~ 44

Author(s):

Anja Gao ◽

Francois Cachat ◽

Mohamed Faouzi ◽

Daniel Bardy ◽

Dolores Mosig ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Schwartz Formula

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Examination of Nephrotoxicity in Survivors of Childhood Cancer and Comparison of Methods for Estimating Glomerular Filtration Rate

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2021.90377 ◽

2021 ◽

Author(s):

Arzu Yazal Erdem ◽

Suna Emir ◽

Nilgün Çakar ◽

Hacı Ahmet Demir ◽

Derya Özyörük

Keyword(s):

Glomerular Filtration Rate ◽

Childhood Cancer ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Childhood Cancer Survivors ◽

High Dose ◽

Schwartz Formula ◽

Treatment Regimens ◽

Survivors Of Childhood Cancer

Objective: Increased survival rates in childhood cancers have led the researchers to focus on long-term side effects and possible risk factors for late nephrotoxicity related to the treatment regimens applied. Our aim is to evaluate drug-induced nephrotoxicity in survivors of childhood cancer and to investigate the compatibility of creatinine clearance with the estimated glomerular filtration rate. Methods: The presence of glomerular and tubular dysfunction has been screened among 59 childhood cancer survivors who had completed their treatment regimens with cisplatin, carboplatin, ifosfamide, and /or high dose methotrexate. Results: The mean age of patients was 10.7±5.5 years (2.5-23), and mean follow-up time was 2.6±2.1 years (0.5-8). Renal dysfunction was detected in 65% of the patients. The most prevalent manifestation of renal dysfunction was decreased glomerular filtration rate (n: 19, 32.2%), and increased urinary β2-microglobulin excretion (n: 12, 20.4%), followed by microalbuminuria (n: 6, 10.1%). Survivors treated with combined chemotherapy regimens (cisplatin, carboplatin, ifosfamide) had significantly lower tubular reabsorption of phosphate than those treated with high dose of methotrexate. The glomerular filtration rate analysis was performed using different methods, and a moderate correlation (r=0.563, p=0.00) was found between estimated glomerular filtration rates calculated according to cystatin-C-based equations and Schwartz formula. Conclusion: Childhood cancer survivors demonstrated a high frequency of renal complications in the current study. We have shown that the calculation of the estimated glomerular filtration rate using the Schwartz formula or cystatin-C-based equations is compatible with the creatinine clearance in this specific patient group. In survivors of childhood cancer who cannot perform 24-hour urine collection, determination of estimated glomerular filtration rate is a more practical approach.

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