The Lund-Malmö creatinine-based glomerular filtration rate prediction equation for adults also performs well in children.
OBJECTIVE
To evaluate the clinical performance in a paediatric population of the Lund-Malmö creatinine-based glomerular filtration rate (GFR) prediction equations, primarily developed for adults.


METHODS
Iohexol clearance was used as the gold standard in 85 paediatric Caucasian patients (0.3-17 years; 37 F/48 M). One Lund-Malmö equation was based on age and gender (LM) and one included lean body mass (LM-LBM). Comparisons focused on correlation (adjusted R2), bias (median percent error) and accuracy (proportions of predicted GFR differing < or = 30% from measured GFR) (mL/min/1.73 m2). The performances were compared with those of the Modification of Diet in Renal Disease (MDRD) Study equation, a dedicated paediatric creatinine equation, Counahan-Barratt (CB) and a cystatin C-based equation.


RESULTS
The MDRD equation performed poorly with a median bias of 96%. Of the remaining equations, only the LM-LBM produced significant bias (+10% in median) according to line of identity regression analysis. The LM equation yielded marginally higher accuracy (76%) than the LM-LBM equation (74%) and the CB (73%), but lower than the cystatin C-based equation (82%). However, the estimated accuracy figures for these four equations were generally imprecise and none of the differences compared with the LM equation was statistically significant.


CONCLUSIONS
In contrast to most creatinine-based GFR prediction equations, the LM equation performs adequately for both children and adults. This may be due to the unique model-building principles used when the LM equation was established. Further validation in a larger paediatric population is necessary.
Department of Radiology, Lasarettet Trelleborg, Trelleborg, Sweden. ulf.nyman@skane.se
Ulf
U
Nyman
Jonas
J
Björk
Veronica
V
Lindström
Anders
A
Grubb
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007223:Infant; D007472:Iohexol; D007677:Kidney Function Tests / Q000592:standards*; D008297:Male; D015203:Reproducibility of Results
D055316:Cystatin C; D007472:Iohexol; D003404:Creatinine