Estimating Glomerular Filtration Rate in Pediatric Populations
Summary
The glomerular filtration rate (GFR) quantifies kidney function by measuring plasma clearance of solutes. In children, direct measurement is invasive and impractical, so estimated GFR (eGFR) equations based on biomarkers such as serum creatinine or cystatin C are widely used. Paediatric estimation must account for growth, muscle mass and developmental changes that affect biomarker levels. Historical formulas have been adapted over time to various age groups, incorporating coefficients that correct for height, age and body surface area. Accurate eGFR is critical for early detection of chronic kidney disease (CKD), monitoring renal trajectories and guiding clinical interventions in paediatric practice around the world.
Research from Nature Portfolio
A prospective study of lifestyle intervention in children and adolescents with overweight and obesity evaluated changes in de-indexed eGFR using two estimation equations. Baseline glomerular hyperfiltration was identified in up to 18 per cent of participants, with significant reductions in de-indexed eGFR after twelve months of weight-management therapy. The findings demonstrated that the magnitude of change and prevalence of hyperfiltration depend on the choice of estimation formula and on whether GFR is normalised to body surface area. This work emphasises the need for consistency in paediatric eGFR methodology when assessing renal function in relation to growth and body composition.
Estimating Glomerular Filtration Rate in Pediatric Populations publication trend
The graph below shows the total number of articles in estimating glomerular filtration rate in pediatric populations across all publications each year (not limited to Nature Index journals).
Technical terms
Glomerular filtration rate (GFR): The volume of plasma filtered through the renal glomeruli per unit time, indicating overall kidney function.
Estimated GFR (eGFR): A calculated value derived from serum biomarkers and patient characteristics to approximate GFR.
Serum creatinine: A waste product of muscle metabolism used as a surrogate marker for GFR; levels vary with muscle mass and age.
Cystatin C: A low molecular weight protein produced by all nucleated cells, used as an alternative biomarker for eGFR less affected by muscle mass.
De-indexing: The process of expressing eGFR in absolute units rather than per body surface area to account for growth and body composition.
Hyperfiltration: A state of abnormally elevated eGFR, often an early sign of renal stress prior to overt decline in function.
References
- Cystatin C as a Marker of Kidney Function in Children. Biomolecules (2024).
- Longitudinal Estimated Glomerular Filtration Rate Trajectories in Children with Type 1 Diabetes. Pediatric Diabetes (2023).
- Glomerular Filtration Rate Assessment in Children. Children (2022).
- The effect of one year lifestyle intervention on eGFR in children and adolescents with overweight, obesity and morbid obesity. Scientific Reports (2019).
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