Automatic Reporting of Creatinine-Based Estimated Glomerular Filtration Rate in Children: Is this Feasible? - European Medical Journal
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Automatic Reporting of Creatinine-Based Estimated Glomerular Filtration Rate in Children: Is this Feasible?

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Authors:
*Andrew Lunn
Disclosure:

The author has declared no conflicts of interest.

Acknowledgements:

Many thanks to Peter Hay for providing Table 2 and for working with me on the local optimisation of formulae in Nottingham. Many thanks to David McCrear and Katherine Jeffs for working with me in the local optimisation of formulae in Nottingham. With thanks also to Stephanie Barber for advice regarding technical aspects of the biochemistry laboratory.

Received:
01.12.15
Accepted:
18.03.16
Citation
EMJ Nephrol. ;4[1]:106-112.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

Abstract

Creatinine, although widely used as a biomarker to measure renal function, has long been known as an insensitive marker of renal impairment. Patients with reduced renal function can have a creatinine level within the normal range, with a rapid rise when renal function is significantly reduced. As of 1976, the correlation between height, the reciprocal of creatinine, and measured glomerular filtration rate (GFR) in children has been described. It has been used to derive a simple formula for estimated glomerular filtration rate (eGFR) that could be used at the bedside as a more sensitive method of identifying children with renal impairment. Formulae based on this association, with modifications over time as creatinine assay methods have changed, are still widely used clinically at the bedside and in research studies to assess the degree of renal impairment in children.

Adult practice has moved in many countries to computer-generated results that report eGFR alongside creatinine results using more complex, but potentially more accurate estimates of GFR, which are independent of height. This permits early identification of patients with chronic kidney disease. This review assesses the feasibility of automated reporting of eGFR and the advantages and disadvantages of this in children.

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