title: Determinants of eGFR at start of renal replacement therapy in paediatric patients.
abstract: BACKGROUND
  Few studies have investigated the determinants of glomerular filtration rate (GFR) in paediatric patients starting on dialysis or with a transplant.
  
  
  METHODS
  Data were collected as part of the European Society of Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association registry from 14 European countries and referred to incident paediatric patients starting on renal replacement therapy (RRT) between 2002 and 2007 under the age of 18 years. Estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula. Data were adjusted for age, gender, treatment modality at start, primary cause of renal failure (PRD) and regions in Europe (eGFR(adj)).
  
  
  RESULTS
  Median eGFR in the 938 patients starting RRT was 10.4 mL/min/1.73 m(2) (5th and 95th percentile: 4.0-26.9). Twenty-six patients (2.8%), mainly infants with Finnish-type nephropathy, started with eGFR levels >50 mL/min/1.73 m(2). Younger age, female gender, starting on dialysis and having a short time between the first visit to a paediatric nephrologist (PN) and start of RRT were associated with lower eGFR at start of RRT. Gender differences were only present during adolescent age and disappeared when using the same K value for both genders. The various PRDs showed large differences in the rate of decline in eGFR between the first visit to a PN and start of RRT; however, this did not result in differences in eGFR(adj) at start of RRT.
  
  
  CONCLUSIONS
  The main determinants of eGFR at start of RRT were age, gender, treatment modality at start, and the time between the first visit to a PN and start of RRT. Research is needed to determine the consequences of these differences.
authors.affiliation: ESPN/ERA-EDTA Registry, Department of Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. K.J.vanStralen@amc.uva.nl
authors.forename: Karlijn J
authors.initials: KJ
authors.lastname: van Stralen
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Tizard
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.forename: Karel
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authors.lastname: Vondrak
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
authors.forename: Ludmila
authors.initials: L
authors.lastname: Podracká
authors.forename: Christer
authors.initials: C
authors.lastname: Holmberg
authors.forename: Augustina
authors.initials: A
authors.lastname: Jankauskiené
authors.forename: M A
authors.initials: MA
authors.lastname: Lewis
authors.forename: Rita
authors.initials: R
authors.lastname: van Damme-Lombaerts
authors.forename: Conceição
authors.initials: C
authors.lastname: Mota
authors.forename: Patrick
authors.initials: P
authors.lastname: Niaudet
authors.forename: Gregor
authors.initials: G
authors.lastname: Novljan
authors.forename: Amira
authors.initials: A
authors.lastname: Peco-Antic
authors.forename: Emilija
authors.initials: E
authors.lastname: Sahpazova
authors.forename: Ulle
authors.initials: U
authors.lastname: Toots
authors.forename: Enrico
authors.initials: E
authors.lastname: Verrina
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017582:Renal Replacement Therapy; D012727:Sex Characteristics