title: Estimation of glomerular filtration rate with and without height: effect of age and renal function level.
abstract: BACKGROUND
  The current glomerular filtration rate (GFR) equation (CKiD) may be less accurate in adolescents and children with higher GFR.
  
  
  METHODS
  This was a retrospective study (n = 161, 247 (99)mTc DTPA-GFRs). Six equations were evaluated for bias, accuracy, and low GFR diagnosis: (1) CKiD; (2) historic center; (3) Hoste(age); (4) Hoste(height); (5) modified Pottel; (6) Gao. Children with ≥ vs. <90 ml/min/1.73 m(2)) and < vs. ≥16 years were compared. Two adult equations were evaluated in children ≥16 years.
  
  
  RESULTS
  Most equations underestimated GFR by 1-14 % in the higher GFR group, least so for Hoste(age). In the low GFR group, Hoste(age) and historic center overestimated GFR significantly more than CKiD (p < 0.05). Accuracy (within 30 % GFR) was similar across equations and GFR subgroups (66-86 %). In the ≥16 years group, CKiD underestimated GFR by ∼10 %, vs. ∼3 % for Hoste(height). Accuracy was 5-10 % lower in the older group and most equations were more sensitive than specific for detecting low GFR; this discrepancy was less for the Hoste equations. Adult equations were highly inaccurate.
  
  
  CONCLUSIONS
  GFR estimation in older children and with higher GFR is suboptimal. The Hoste(height) may be an alternative GFR estimation method; Hoste(age) may allow for height-independent GFR estimation in patients with normal GFR.
authors: Department of Pediatrics, McGill University Health Centre, Montreal Children's Hospital, 2300 Tupper, Room E-213, Montreal, QC, Canada, H3H 1P3.
authors: Nikki
authors: N
authors: Rink
authors: Michael
authors: M
authors: Zappitelli
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D010372:Pediatrics / Q000379:methods*; D012189:Retrospective Studies