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Estimated glomerular filtration rates cannot replace measured GFR in type 1 diabetes patients with hyperfiltration
Author(s) -
Perrin NES,
Berg UB
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12993
Subject(s) - medicine , renal function , glomerular hyperfiltration , urology , diabetes mellitus , type 2 diabetes , type 1 diabetes , filtration (mathematics) , filtration fraction , endocrinology , diabetic nephropathy , renal blood flow , statistics , mathematics
Aim This study of children and young adults with type 1 diabetes with normal to high glomerular filtration rates ( GFR ) compared estimated GFR ( eGFR ) with measured GFR ( mGFR ). Methods GFR was measured by inulin clearance, and we carried out simultaneous analyses of standardised creatinine and cystatin C. eGFR was calculated using different formulas. Results We enrolled 106 patients, including 56 males, aged 21.9 (standard deviation 9.2) years with 13.7 (9.1) years' duration of diabetes and a mean haemoglobin A1c (HbA 1c ) of 7.7% (61 mmol/mol). The median mGFR was 128 (111–143) mL/min/1.73 m 2 . Most of the eGFR estimations failed to detect a significant proportion of hyperfiltration based on inulin clearance. The best accuracy (P30) between eGFR and mGFR was seen with eGFR CKD ‐ EPI (92%), eGFR cys C Berg (86%), eGFR cys C CAPA (78%) and eGFR cys C Inker (84%) where eGFR CKD ‐ EPI and eGFR cys C Berg showed the lowest bias. Most eGFR cys C measurements showed greater accuracy when combined with eGFR cr (P30 92–94%). Conclusion The best accuracy (P30) and lowest bias were found with eGFR CKD ‐ EPI and eGFR Berg. in this cohort. However, eGFR cannot accurately replace mGFR to detect hyperfiltration and follow GFR over time in young patients with type 1 diabetes.