Comparative study of cystatin C and serum creatinine in the estimative of glomerular filtration rate in children

Vânia F Cordeiro, Diana C S N Pinheiro, Geraldo B Silva, José Wellington O Lima, Rosa M S Mota, Alexandre B Libório, Elizabeth F Daher
Clinica Chimica Acta; International Journal of Clinical Chemistry 2008, 391 (1): 46-50

BACKGROUND: To compare estimated glomerular filtration rate (GFR) by Schwartz formula and cystatin C-derived formula in a large population of children with a large spectrum of renal disease.

METHODS: Serum creatinine, cystatin C and estimated GFR were determined in 273 children, 254 with renal disease, and a mean age of 10.0+/-4.4 y. Nineteen children were used as control, with a mean age of 8.5+/-4.2 y.

RESULTS: The children had nephrotic syndrome (16.5%), glomerulonephritis (11.4%), neurogenic bladder (11.4%), hydronephrosis (9.8%), asymptomatic hematuria (11%), chronic renal disease (5.9%) and other diseases (11%). Cystatin C, creatinine, Schwartz estimated GFR and cystatin C estimated GFR (mean+/-SD) were 1.30+/-1.03 mg/dl, 0.82+/-1.20 mg/l, 143+/-72 ml/min/1.73 m(2) and 88+/-36 ml/min/1.73 m(2), respectively. Although GFR estimated by creatinine and cystatin C had a significant correlation, the Bland-Altman analysis showed greater differences between GFR estimated by the 2 methods, with a mean difference of 50 ml/min. Besides, >50% of the patients with a reduced cystatin C estimated GFR had a normal GFR when analyzed by the Schwartz formula.

CONCLUSIONS: Our data shows that cystatin C-based GFR is more sensitive than previous study had demonstrated. It is important to perform studies in specific populations to determine the variability in GFR measurements.

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