Comparison of GFR estimation equations using creatinine, cystatin C, and their combination in pediatric hematology–oncology: no single equation is superior across subgroups.

Background: Accurate assessment of renal function is essential in treating pediatric patients dosed with nephrotoxic chemotherapy. The validity of the bedside Schwartz, 5-covariate St. Jude (5SJ), CKiD-CysC-U25, combined Cr-CysC-based CysPed, and the serum creatinine-BUN-cystatin C-based CKiD (CKiD...

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Publicado en:Pediatric Nephrology Vol. 40; no. 9; pp. 2907 - 2918
Autores principales: Phillips, Katelyn J., Sun, Yilun, Tang, Li, Pappas, Andrew, Cross, Shane J., Pauley, Jennifer L., McCormick, John, Molinelli, Alejandro R., Bissler, John J., Christensen, Anthony M., Stewart, Clinton F.
Formato: equations & formulas research tables/charts Journal Article
Publicado: Springer Nature Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
      vid: 40
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-025-06765-7
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        atl: Comparison of GFR estimation equations using creatinine, cystatin C, and their combination in pediatric hematology–oncology: no single equation is superior across subgroups.
      aug:
        au:
          Phillips, Katelyn J.
          Sun, Yilun
          Tang, Li
          Pappas, Andrew
          Cross, Shane J.
          Pauley, Jennifer L.
          McCormick, John
          Molinelli, Alejandro R.
          Bissler, John J.
          Christensen, Anthony M.
          Stewart, Clinton F.
        affil: https://ror.org/02r3e0967 Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, 262 Danny Thomas Place, 38105, Memphis, TN, USA
      sug:
        subj:
          Data Analysis, Statistical
          Glomerular Filtration Rate
          Creatinine Blood
          Cystatin C Blood
          Hematology
          Oncology
          Pediatrics
          Human
          Male
          Female
          Infant
          Child, Preschool
          Child
          Adolescence
          Retrospective Design
          Record Review
          Technetium
          Carboplatin
          Funding Source
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Background: Accurate assessment of renal function is essential in treating pediatric patients dosed with nephrotoxic chemotherapy. The validity of the bedside Schwartz, 5-covariate St. Jude (5SJ), CKiD-CysC-U25, combined Cr-CysC-based CysPed, and the serum creatinine-BUN-cystatin C-based CKiD (CKiD Cr-CysC) equations were evaluated in pediatric hematology and oncology patients. Methods: A retrospective analysis was conducted comparing estimated glomerular filtration rate (eGFR) to measured GFR (mGFR) obtained from technetium- 99 m diethylenetriaminepentaacetic acid (99 mTc-DTPA) clearance between January 2016 and May 2022. The influence of corticosteroid use and inflammation in our patient population was evaluated for effect on serum cystatin C (CysC) concentrations and mGFR. Results: All equations agreed within 2 SD of the mean difference with mGFR, but the 5SJ equation had the smallest bias followed closely by the CysPed equation. Overall accuracy (P30) was assessed, and the 5SJ, CKiD Cr-CysC, CysPed, and CKiD-Cys-U25 exhibited comparable performance. In our patient population, we did not observe an effect of corticosteroids (cumulative dosage of > 0.5 mg/kg within the past 14 days) or the presence of inflammation (CRP > 1.2 mg/L) on cystatin C concentrations or mGFR. Conclusions: In our pediatric hematology and oncology patient population, no one estimating equation demonstrated superior accuracy and bias overall and in all subgroups. Neither corticosteroid use nor elevated CRP influenced serum CysC concentrations or eGFR.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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