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Renal concentrating capacity as a marker for glomerular filtration rate
Author(s) -
Nieto Víctor M García,
Yanes María Isabel Luis,
Zamorano Margarita Monge,
González Ma José Hernández,
Aros Carolina Peralta,
Garin Eduardo H
Publication year - 2008
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2007.00587.x
Subject(s) - medicine , renal function , urinary system , urine osmolality , urology , urine , creatinine , endocrinology , desmopressin , osmole
Aim: We have studied 160 children with a variety of renal diseases, 14 of them with chronic renal failure (CRF), to evaluate maximum urinary osmolality as a predictor of glomerular filtration rate (GFR) testing the hypothesis that a normal GFR is necessary to have a normal urinary concentrating capacity. Methods: All patients had a serum creatinine measured. GFR was calculated according to the Schwartz formula. All patients underwent desmopressin (DDAVP) test to evaluate renal concentrating capacity. Results: Patients with CRF were unable to concentrate the urine beyond 486 mosm/kg whereas all patients with a normal concentrating capacity (urine osmolality > 835 mosm/kg) had a normal GFR. Desmopressin test sensitivity to detect CRF was 100% and specificity 70.5%. A significant negative correlation was found between urinary osmolality after DDAVP administration and serum creatinine levels and between urinary volume corrected by 100 mL of GFR (V/GFR) and urinary osmolality. Conclusion: In our series, a normal concentrating capacity was always associated with a normal GFR while all patients with decreased GFR had a concentrating capacity defect. Thus, in the evaluation of infants and children with renal disease, the finding of a normal urinary concentrating capacity will suggest and intact glomerular and tubular function.