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NDT Advance Access published online on September 11, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn505
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Body mass does not have a clinically relevant effect on Cystatin C eGFR in children

Ajay P. Sharma1, Anusha Kathiravelu2, Renisha Nadarajah2, Abeer Yasin1 and Guido Filler1

1 Department of Paediatrics, Division of Paediatric Nephrology, Children's Hospital, London Health Science Centre, University of Western Ontario, London 2 Division of Pediatric Nephrology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada

Correspondence and offprint requests to: Guido Filler, Children's Hospital, London Health Science Centre, University of Western Ontario, 800 Commissioner's Road East, London, Ontario, N6A 5W9, Canada. Tel: +1-519-685-8377; Fax: +1-519-685-8551; E-mail: guido.filler{at}lhsc.on.ca



  Abstract

Background. Unlike creatinine, Cystatin C (CysC) is believed to be independent of body composition in both adults and children. Recent findings in adults, suggesting an improved performance of CysC-based estimated glomerular filtration rate (CysC eGFR) by accounting for body mass, necessitated a careful re-evaluation of this issue in children.

Methods. We studied 240 children (median age 11.7 years, range 2–17.9 years, 107 girls), with various kidney diseases, for any change in the relationship between 99Tc DTPA GFR and CysC eGFR after accounting for body mass. For body mass assessment, body mass index (BMI) z-score was calculated using height-adjusted age, to account for growth retardation secondary to chronic kidney disease.

Results. CysC eGFR did not have a significant correlation with BMI z-score (correlation coefficient = 0.06; P = 0.34). Accounting for BMI z-score did not add to the 65% variance in nuclear GFR explained by CysC eGFR. Moreover, it did not change the regression coefficient of 0.85 between CysC eGFR and nuclear GFR either. On Bland & Altman analysis, the bias of 0.05 and standard deviation of 20.39 also did not improve after accounting for BMI z-score in the revised CysC eGFR formula.

Conclusions. In children, body mass exerts a minimal effect on the performance of CysC eGFR estimation.

Keywords: body composition; body mass index; Cystatin C; obesity; z-score

Received for publication: 11. 4.08
Accepted in revised form: 18. 8.08


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