The Lund–Malmö creatinine‐based glomerular filtration rate prediction equation for adults also performs well in children

Abstract

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. Material and 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 ⩽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. Conclusion. 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.

• Drug therapy
• glomerular filtration rate
• kidney disease
• kidney function tests
• renal insufficiency