scholarly journals P25 Comparison of renal function estimation methods in critically ill children: a pilot study

2019 ◽  
Vol 104 (6) ◽  
pp. e27.1-e27
Author(s):  
E Dhont ◽  
T Van Der Heggen ◽  
A De Jaeger ◽  
J Willems ◽  
S De Baere ◽  
...  
Keyword(s):  
Renal Function ◽  
Intensive Care ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Critically Ill ◽  
Filtration Rate ◽  
University Hospital ◽  
Estimation Methods ◽  
Critically Ill Children ◽  
List Type

BackgroundAccurate assessment of renal function is crucial in intensive care to guide therapy. Both acute kidney injury and augmented renal clearance (ARC) may compromise outcome. Common formulas to estimate glomerular filtration rate (GFR) are unreliable in critically ill adults.1 A comparison of a gold standard technique to assess GFR with these formula-based estimations has never been reported in pediatric intensive care (PICU) patients. Our aim was to evaluate the feasibility of measuring plasma iohexol clearance (CLIOHEX) for GFR assessment in critically ill children and to compare CLIOHEX with estimated GFR using the modified Schwartz formula (eGFRSchwartz).MethodsA prospective, interventional study was conducted at the PICU of the Ghent University Hospital, Belgium. Critically ill children without chronic kidney disease were included. After injection of a weight-dependent bolus of iohexol, serial blood samples (n=6) were taken over a 6-hours interval. CLIOHEX was compared to eGFRSchwartz. Correlation between both methods was assessed by a Pearson´s correlation coefficient (r).Bland-Altman plots were evaluated to assess bias and limits of agreement (LOA). ARC was defined as a GFR exceeding normal values for age plus two standard deviations.Results40 patients, median age 16 months (range 15 days -13,6 years), 72,5% males, were included. No adverse effects related to iohexol were observed. Median CLIOHEX was 121 ml/min/1.73m2 (range: 43–221 ml/min/1.73m2). ARC was present in 20 patients based on CLIOHEX. Median eGFRSchwartz was 81 ml/min/1.73m2 (range: 31–131 ml/min/1.73m2). Only 1 patient was identified with ARC by eGFRSchwartz. eGFRSchwartz was systematically lower than CLIOHEX. There was a good correlation between CLIOHEX and eGFRSchwartz (r = 0,69; p< 0,01). Bias was 34 ml/min/1.73m2 with LOA (-24,5; 93 ml/min/1.73m2)ConclusionCLIOHEX was safely used to measure true GFR in critically ill children. eGFRSchwartz systematically underestimates GFR, especially in patients with ARC and seems not reliable in this patient population.ReferenceBaptista JP, Neves M, Rodrigues L, Teixeira L, Pinho J, Pimentel J ( 2014) Accuracy of the estimation of glomerular filtration rate within a population of critically ill patients. J Nephrol. 27:403–410.Disclosure(s)Nothing to disclose

scholarly journals Utility of kinetic glomerular filtration rate for predicting severe persistent acute kidney injury in critically ill children and young adults

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0006892020
Author(s):  
Shina Menon ◽  
Rajit K Basu ◽  
Matthew F Barhight ◽  
Stuart L Goldstein ◽  
Katja M Gist
Keyword(s):  
Acute Kidney Injury ◽  
Young Adults ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Critically Ill ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Early Access ◽  
Children And Young Adults

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Evaluation of renal function in intensive care: plasma cystatin C vs. creatinine and derived glomerular filtration rate estimates

2005 ◽  
Vol 43 (9) ◽  
Author(s):  
Thierry Le Bricon ◽  
Isabelle Leblanc ◽  
Mourad Benlakehal ◽  
Cécile Gay-Bellile ◽  
Danielle Erlich ◽  
...  
Keyword(s):  
Renal Function ◽  
Intensive Care ◽  
Glomerular Filtration Rate ◽  
Phase I ◽  
Glomerular Filtration ◽  
Phase Ii ◽  
Cystatin C ◽  
Filtration Rate ◽  
Full Range ◽  
Surgical Intensive Care

AbstractPlasma cystatin C, a new marker of glomerular filtration rate (GFR), was prospectively evaluated in surgical intensive care. Cystatin C was measured (immunonephelometry, Dade-Behring) in 10 patients selected to cover a full range of GFR (phase I) and in 28 unselected consecutive patients followed for 5days post-admission (phase II). Results were compared with

scholarly journals Measurement of glomerular filtration rate in lung transplant recipients highlights a dramatic loss of renal function after transplantation

2020 ◽  
Vol 13 (5) ◽  
pp. 828-833
Author(s):  
Nans Florens ◽  
Laurence Dubourg ◽  
Laurent Bitker ◽  
Emilie Kalbacher ◽  
François Philit ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Lung Transplant ◽  
Filtration Rate ◽  
University Hospital ◽  
Post Transplantation ◽  
Ckd Stage

Abstract Background Chronic kidney disease (CKD) after lung transplantation (LT) is underestimated. The aim of the present study was to measure the loss of glomerular filtration rate (GFR) 1 year after LT and to identify the risk factors for developing Stage ≥3 CKD. Methods LT patients in the University Hospital of Lyon had a pre- and post-transplantation measurement of their GFR (mGFR), and GFR was also estimated using the Chronic Kidney Disease Epidemiology Collaboration equation. Results During the study period, 111 patients were lung transplant candidates, of which 91 had a pre-transplantation mGFR, and 29 had a mGFR at 1 year after LT. Six patients underwent maintenance haemodialysis after transplantation. Mean mGFR was 106 mL/min/1.73 m2 before LT and 58 mL/min/1.73 m2 1 year after LT (P &lt; 0.05) with a mean loss of 48 mL/min/1.73 m2 per patient. The risk of developing Stage ≥3 CKD after LT was higher in patients with lower pre-LT mGFR (odds ratio for each 1 mL/min/1.73 m2 increase: 0.94, 95% confidence interval 0.88–0.99). Receiver operator characteristics curves for the sensitivity and specificity of eGFR and mGFR for the prediction of CKD Stage ≥3 after LT found that pre-LT mGFR of 101 mL/min/1.73 m2 and pre-LT eGFR of 124 mL/min/1.73 m2 were the optimal thresholds for predicting Stage ≥3 CKD after LT. Conclusion The present study underlines the value of mGFR in the pre-LT stage and found major renal function loss after LT, and consequently two-thirds of patients have Stage ≥3 CKD at 1 year. All patients with a pre-LT mGFR &lt;90 mL/min/1.73 m2 warrant particular attention.

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