Applicalibity of various estimation formulas to evaluate renal glomerular filtration rate in children with chronic kidney disease

Objective This study was to evaluate the relative applicability of serum cystatin C(Cys C)-based formulas and serum creatinine-based formulas for renal glomerular filtration rate (GFR) of Chinese children with chronic kidney disease (CKD). Methods Six hundred and nine Chinese CKD patients of less than 18 years old were enrolled from January 2011 to October 2016 in Shengjing Hospital of China Medical University.The value for estimated GFR (eGFR) was derived from using the 11 formulas, and 99mTc-DTPA renal dynamic imaging was the golden standard of standard GFR(sGFR). SPSS 22.0 statistical software was used to compare the accuracy of each assessment formula and the correlation between GFR markers (Cys C, β2-MG) and sGFR. Results A total of 609 children were enrolled, including 332 patients in CKD stage 1(211 males and 121 females), 165 patients in CKD stage 2(99 males and 66 females), 70 patients in CKD stage 3(43 males and 27 females), 22 patients in CKD stage 4(13 males and 9 females), and 20 patients in CKD stage 5(16 males and 4 females). All of the formulas either overestimate or underestimate GFR in children with CKD.In contrast with other formulas, CKD-EPI formula and Filler formula performed better regardless of gender and age difference.Serum β2-MG and serum Cys C all showed a negative relationship with sGFR(respectively r=-0.478 and r=-0.585, P<0.01). Conclusion CKD-EPI formula and Filler formula provide the better approximation to sGFR than other formulas in Chinese children with CKD.However, we need to try our best to enroll more patients to develop a more accurate GFR estimation formula in Chinese children. Key words: Chronic kidney disease; Renal glomerular filtration rate; Cystatin C; Serum creatinine,