Emil den Bakker1, Berend Koene2, Joanna A E van Wijk2, Isabelle Hubeek3, Reinoud Gemke4, Arend Bökenkamp2. 1. Department of Pediatric Nephrology, VU University Medical Center, De Boelelaan 1112, 1081 HV, Amsterdam, The Netherlands. e.denbakker@outlook.com. 2. Department of Pediatric Nephrology, VU University Medical Center, De Boelelaan 1112, 1081 HV, Amsterdam, The Netherlands. 3. Department of Clinical Chemistry, VU University Medical Centre, Amsterdam, The Netherlands. 4. Department of Pediatrics, VU University Medical Centre, Amsterdam, The Netherlands.
Abstract
BACKGROUND: While glucocorticosteroids (GCS) are widely used in patients with kidney disease, little is known about their effect on serum creatinine, the most commonly used endogenous marker of kidney function. METHODS: We assessed the effect of GCS on the relationship between estimated GFR using the Schwartz equation (eGFR) and measured GFR using a single-injection inulin clearance (Cin) in children both in a paired analysis and a cross-sectional study. Primary outcome variable was the difference between eGFR and Cin (ΔGFR) in a paired analysis involving 22 patients during and off GCS treatment (mean GFR 103.8 ml/min/1.73 m2, mean prednisone dose 34.8 mg/m2/day). In a cross-sectional analysis in 42 patients receiving GCS (mean dose of 25.7 mg/m2/day), a dose-dependent effect was explored using univariate and multivariate linear regression of various variables including GCS dosage with serum creatinine as dependent variable. RESULTS: The paired analysis showed no significant difference in ΔGFR with or without GCS [- 23 (SD 53) vs. - 9 (SD 41) ml/min/1.73 m2, p = 0.203]. Stepwise multivariate linear regression analysis showed a significant correlation between age and Cin, while GCS dose was not related to serum creatinine. CONCLUSION: GCS use had no significant effect on serum creatinine as a marker for kidney function in a mixed population of renal outpatient clinic children.
BACKGROUND: While glucocorticosteroids (GCS) are widely used in patients with kidney disease, little is known about their effect on serum creatinine, the most commonly used endogenous marker of kidney function. METHODS: We assessed the effect of GCS on the relationship between estimated GFR using the Schwartz equation (eGFR) and measured GFR using a single-injection inulin clearance (Cin) in children both in a paired analysis and a cross-sectional study. Primary outcome variable was the difference between eGFR and Cin (ΔGFR) in a paired analysis involving 22 patients during and off GCS treatment (mean GFR 103.8 ml/min/1.73 m2, mean prednisone dose 34.8 mg/m2/day). In a cross-sectional analysis in 42 patients receiving GCS (mean dose of 25.7 mg/m2/day), a dose-dependent effect was explored using univariate and multivariate linear regression of various variables including GCS dosage with serum creatinine as dependent variable. RESULTS: The paired analysis showed no significant difference in ΔGFR with or without GCS [- 23 (SD 53) vs. - 9 (SD 41) ml/min/1.73 m2, p = 0.203]. Stepwise multivariate linear regression analysis showed a significant correlation between age and Cin, while GCS dose was not related to serum creatinine. CONCLUSION: GCS use had no significant effect on serum creatinine as a marker for kidney function in a mixed population of renal outpatient clinic children.
Authors: Arend Bökenkamp; Cèleste A R C Laarman; Katja I Braam; Joanna A E van Wijk; Wijnanda A Kors; Marijke Kool; Janneke de Valk; Anna A Bouman; Marieke D Spreeuwenberg; Birgit Stoffel-Wagner Journal: Clin Chem Date: 2007-12 Impact factor: 8.327
Authors: Hester N Blufpand; Jorien Tromp; Floor C H Abbink; Birgit Stoffel-Wagner; Anneke A Bouman; Antoinette Y N Schouten-van Meeteren; Joanna A E van Wijk; Gertjan J L Kaspers; Arend Bökenkamp Journal: Pediatr Blood Cancer Date: 2011-04-01 Impact factor: 3.167
Authors: David Duncker; Hanno Oswald; Ajmal Gardiwal; Ulrich Lüsebrink; Thorben König; Hendrik Schreyer; Gunnar Klein Journal: J Cardiovasc Pharmacol Ther Date: 2012-07-26 Impact factor: 2.457