title: Assessment of adult formulas for glomerular filtration rate estimation in children.
abstract: BACKGROUND
  Estimated glomerular filtration rate (eGFR) is an important diagnostic instrument in clinical practice. The National Kidney Foundation-Kidney Disease Quality Initiative (NKF-KDOQI) guidelines do not recommend using formulas developed for adults to estimate GFR in children; however, studies confirming these recommendations are scarce. The aim of our study was to evaluate the accuracy of the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, the Modification of Diet in Renal Disease (MDRD) formula, and the Cockcroft-Gault formula in children with various stages of chronic kidney disease (CKD).
  
  
  METHODS
  A total of 550 inulin clearance (iGFR) measurements for 391 children were analyzed. The cohort was divided into three groups: group 1, with iGFR >90 ml/min/1.73 m(2); group 2, with iGFR between 60 and 90 ml/min/1.73 m(2); group 3, with iGFR of <60 ml/min/1.73 m(2).
  
  
  RESULTS
  All formulas overestimate iGFR with a significant bias (p < 0.001), present poor accuracies, and have poor Spearman correlations. For an accuracy of 10 %, only 11, 6, and 27 % of the eGFRs are accurate when using the MDRD, CKD-EPI, and Cockcroft-Gault formulas, respectively. For an accuracy of 30 %, these formulas do not reach the NKF-KDOQI guidelines for validation, with only 25, 20, and 70 % of the eGFRs, respectively, being accurate.
  
  
  CONCLUSIONS
  Based on our results, the performances of all of these formulas are unreliable for eGFR in children across all CKD stages and cannot therefore be applied in the pediatric population group.
authors.affiliation: Division of Paediatric Nephrology, Department of Pediatrics, Lausanne University Hospital, Rue Bugnon 46, 1011 Lausanne, Switzerland. hassib.chehade@chuv.ch
authors.forename: Hassib
authors.initials: H
authors.lastname: Chehade
authors.forename: Eric
authors.initials: E
authors.lastname: Girardin
authors.forename: Katia
authors.initials: K
authors.lastname: Iglesias
authors.forename: Pascal
authors.initials: P
authors.lastname: Ramseyer
authors.forename: Peter
authors.initials: P
authors.lastname: Frey
authors.forename: Daniel
authors.initials: D
authors.lastname: Bardy
authors.forename: Dolores
authors.initials: D
authors.lastname: Mosig
authors.forename: Francois
authors.initials: F
authors.lastname: Cachat
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D009398:Nephrology / Q000592:standards*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis*