Dana F Work1, George J Schwartz. 1. Department of Pediatrics, University of Rochester School of Medicine, Rochester, New York 14618, USA.
Abstract
PURPOSE OF REVIEW: Glomerular filtration rate is the best determinant of kidney function in children. A decline in glomerular filtration rate may be the only sign of renal disease. A knowledge of glomerular filtration rate allows the clinician to appropriately dose medications, administer fluids, and intervene early to prevent end-stage renal failure. The aim of this review is to discuss the current options for determining glomerular filtration rate in children and the latest advances in research on this topic. RECENT FINDINGS: Owing to the limited availability of inulin, the gold standard for measuring glomerular filtration rate, and the concern for using radioactivity, the plasma disappearance of iohexol has been utilized to measure glomerular filtration rate in children, and this represents a practical option for glomerular filtration rate determination in both clinical and research studies. By contrast, creatinine-based estimates of glomerular filtration rate (e.g. Schwartz formula) are more practical for bedside use. To improve their precision, recent formulas have incorporated the use of additional endogenous markers, such as cystatin C, albumin, and blood urea nitrogen. SUMMARY: Iohexol plasma clearances should be used to accurately measure glomerular filtration rate in children. New estimating equations with multiple endogenous markers are being developed for everyday clinical use. However, at present, there is no substitute for an accurate glomerular filtration rate determination, particularly in children with conditions affecting muscle mass or body habitus.
PURPOSE OF REVIEW: Glomerular filtration rate is the best determinant of kidney function in children. A decline in glomerular filtration rate may be the only sign of renal disease. A knowledge of glomerular filtration rate allows the clinician to appropriately dose medications, administer fluids, and intervene early to prevent end-stage renal failure. The aim of this review is to discuss the current options for determining glomerular filtration rate in children and the latest advances in research on this topic. RECENT FINDINGS: Owing to the limited availability of inulin, the gold standard for measuring glomerular filtration rate, and the concern for using radioactivity, the plasma disappearance of iohexol has been utilized to measure glomerular filtration rate in children, and this represents a practical option for glomerular filtration rate determination in both clinical and research studies. By contrast, creatinine-based estimates of glomerular filtration rate (e.g. Schwartz formula) are more practical for bedside use. To improve their precision, recent formulas have incorporated the use of additional endogenous markers, such as cystatin C, albumin, and blood ureanitrogen. SUMMARY:Iohexol plasma clearances should be used to accurately measure glomerular filtration rate in children. New estimating equations with multiple endogenous markers are being developed for everyday clinical use. However, at present, there is no substitute for an accurate glomerular filtration rate determination, particularly in children with conditions affecting muscle mass or body habitus.
Authors: Victor G Romanenko; Tetsuji Nakamoto; Marcelo A Catalán; Mireya Gonzalez-Begne; George J Schwartz; Yasna Jaramillo; Francisco V Sepúlveda; Carlos D Figueroa; James E Melvin Journal: Am J Physiol Gastrointest Liver Physiol Date: 2008-09-18 Impact factor: 4.052
Authors: Rodrigo B Interiano; M Beth McCarville; Noel Delos Santos; Shenghua Mao; Jianrong Wu; Jeffrey S Dome; Kathleen Kieran; Mark A Williams; Rachel C Brennan; Matthew J Krasin; Daniel M Green; Andrew M Davidoff Journal: J Pediatr Surg Date: 2016-10-27 Impact factor: 2.545
Authors: Derek K S Ng; George J Schwartz; Lisa P Jacobson; Frank J Palella; Joseph B Margolick; Bradley A Warady; Susan L Furth; Alvaro Muñoz Journal: Kidney Int Date: 2011-06-08 Impact factor: 10.612
Authors: Rosanna Coppo; Danilo Lofaro; Roberta R Camilla; Shubha Bellur; Daniel Cattran; H Terence Cook; Ian S D Roberts; Licia Peruzzi; Alessandro Amore; Francesco Emma; Laura Fuiano; Ulla Berg; Rezan Topaloglu; Yelda Bilginer; Loreto Gesualdo; Rosaria Polci; Malgorzata Mizerska-Wasiak; Yasar Caliskan; Sigrid Lundberg; Giovanni Cancarini; Colin Geddes; Jack Wetzels; Andrzej Wiecek; Magdalena Durlik; Stefano Cusinato; Cristiana Rollino; Milena Maggio; Manuel Praga; Hilde K Smerud; Vladimir Tesar; Dita Maixnerova; Jonathan Barratt; Teresa Papalia; Renzo Bonofiglio; Gianna Mazzucco; Costantinos Giannakakis; Magnus Soderberg; Diclehan Orhan; Anna Maria Di Palma; Jadwiga Maldyk; Yasemin Ozluk; Birgitta Sudelin; Regina Tardanico; David Kipgen; Eric Steenbergen; Henryk Karkoszka; Agnieszka Perkowska-Ptasinska; Franco Ferrario; Eduardo Gutierrez; Eva Honsova Journal: Pediatr Nephrol Date: 2016-08-25 Impact factor: 3.714
Authors: David T Selewski; David J Askenazi; Brian C Bridges; David S Cooper; Geoffrey M Fleming; Matthew L Paden; Mark Verway; Rashmi Sahay; Eileen King; Michael Zappitelli Journal: Pediatr Crit Care Med Date: 2017-12 Impact factor: 3.624