Comparison of cystatin C, creatinine, and iohexol clearance in pediatric liver transplantation—a retrospective cohort study

Impaired renal function after pediatric (LT) is a recognized problem. Accurate monitoring of (GFR) is imperative to detect declining renal function. GFR can be estimated via s‐creatinine and/or p‐cystatin C or measured by inulin and or/iohexol clearances. We retrospectively compared eGFRcrea and eGF...

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Bibliographic Details
Published in:Pediatric transplantation 2021-09, Vol.25 (6), p.e13993-n/a
Main Authors: Bluhme, Emil, Malenicka, Silvia, Fischler, Bjorn, Nemeth, Antal, Berg, Ulla B., Jorns, Carl
Format: Article
Language:English
Subjects:
Adolescent
Bias
Biomarkers - blood
Child
Child, Preschool
Cohort analysis
Creatinine
Creatinine - blood
Cystatin C
Cystatin C - blood
Epidermal growth factor receptors
Female
Glomerular Filtration Rate
Humans
Infant
Inulin
Iohexol - metabolism
iohexol clearance
Kidney Function Tests
Liver Transplantation
Liver transplants
Male
Mathematics
Medicin och hälsovetenskap
Patients
pediatric liver transplantation
Pediatrics
Renal function
Retrospective Studies
Sweden
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Summary:Impaired renal function after pediatric (LT) is a recognized problem. Accurate monitoring of (GFR) is imperative to detect declining renal function. GFR can be estimated via s‐creatinine and/or p‐cystatin C or measured by inulin and or/iohexol clearances. We retrospectively compared eGFRcrea and eGFRcyst, to mGFRiohex after LT. Data from 91 children with 312 concomitant measurements of s‐creatinine, p‐cystatin C, and iohexol clearance, obtained between 2007 and 2015, were analyzed. eGFR was calculated by using the p‐cystatin C‐based CAPA and CKD‐EPI formulas, and the s‐creatinine‐based Schwartz‐LYON, FAS, revised Schwartz and MDRD formulas. Also, the arithmetic means of cystatin C‐based and creatinine‐based equations were used. Every calculated eGFR was compared to mGFRiohex in statistical correlation, accuracy, precision, bias, and misclassifications. Among the different equations, p‐cystatin C‐based formulas (CAPA and CKD‐EPI) as well as the s‐creatinine‐based Schwartz‐LYON formula showed the most correct estimates regarding accuracy (84–87.5%), bias (0.19–4.0 ml/min/1.73 m2), and misclassification rate (24.7–25%). In patients with renal function
ISSN:1397-3142
1399-3046
1399-3046
DOI:10.1111/petr.13993