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Roussel M, Bacchetta J, Sellier-Leclerc AL, Lemoine S, De Mul A, Derain Dubourg L. Creatinine-based formulas are not ideal to estimate glomerular filtration rate in selected pediatric patients: data from a tertiary pediatric nephrology center. Pediatr Nephrol 2024:10.1007/s00467-023-06275-4. [PMID: 38884786 DOI: 10.1007/s00467-023-06275-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 06/18/2024]
Abstract
BACKGROUND Evaluating glomerular filtration rate (GFR) remains challenging in pediatrics; new formulas were developed to increase performance of GFR estimation (eGFR). We aimed to evaluate the recently published formulas as applied to another pediatric population. METHODS A retrospective study was conducted in a cohort of 307 patients with a "kidney risk" (mean age 12.1 ± 4.5 years, sex ratio 1/1) assessed in a tertiary pediatric nephrology center and a mean measured GFR (mGFR) using plasma iohexol clearance of 85.5 ± 25.3 mL/min/1.73 m2; creatinine levels were measured by IDMS-standardized enzymatic method and cystatin C by immunonephelometry. The following eGFRs were calculated: Schwartz2009, Schwartz-Lyon, CKiDU25creat, and EKFC for eGFR using creatinine (eGFR-creat), CKiDU25cys and FAScys for eGFR using cystatin (eGFR-cys) as well as combined SchwartzCreat-Cys, average (CKiDU25creat-CKiDU25cys), and average (EKFC-FAScys) for eGFR using both biomarkers. The performance of the different formulas was evaluated compared to mGFR by absolute bias measurement and accuracy (p10%, p30%). Results are expressed as mean ± SD. RESULTS Creatinine-based formulas and especially the new CKiDU25 and EKFC overestimate GFR, even in children with normal kidney function. However, the bias is constant with these two formulas whatever the age group or gender, contrary to the previously published formulas. In contrast, cystatin C-based equations and combined formulas showed good performance in all age groups and all medical conditions with an acceptable bias and p30%. CONCLUSIONS In our pediatric population, the performance of all creatinine-based formulas is inadequate with significant GFR overestimation, mainly in subjects with mGFR > 75 mL/min/1.73 m2. Conversely, cystatin C-based or combined formulas have acceptable performance in patients followed in a tertiary pediatric nephrology unit.
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Affiliation(s)
- Mathilde Roussel
- Service de Néphrologie Rhumatologie et Dermatologie Pédiatrique, Centre de Référence Des Maladies Rénales Rares, Filière Maladies Rares ORKID and ERKNet, Hospices Civils de Lyon, Bron, France
| | - Justine Bacchetta
- Service de Néphrologie Rhumatologie et Dermatologie Pédiatrique, Centre de Référence Des Maladies Rénales Rares, Filière Maladies Rares ORKID and ERKNet, Hospices Civils de Lyon, Bron, France
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France
- INSERM 1033 Research Unit, Université de Lyon, Lyon, France
| | - Anne Laure Sellier-Leclerc
- Service de Néphrologie Rhumatologie et Dermatologie Pédiatrique, Centre de Référence Des Maladies Rénales Rares, Filière Maladies Rares ORKID and ERKNet, Hospices Civils de Lyon, Bron, France
| | - Sandrine Lemoine
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France
- Hospices Civils de Lyon, Hôpital E. Herriot, Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, 69003, Lyon, France
- CarMeN Laboratory, Inserm U1060, INRA U1397, Université Claude Bernard Lyon 1, 69500, Bron, France
| | - Aurélie De Mul
- Service de Néphrologie Rhumatologie et Dermatologie Pédiatrique, Centre de Référence Des Maladies Rénales Rares, Filière Maladies Rares ORKID and ERKNet, Hospices Civils de Lyon, Bron, France
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France
- Hospices Civils de Lyon, Hôpital E. Herriot, Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, 69003, Lyon, France
| | - Laurence Derain Dubourg
- Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France.
- Hospices Civils de Lyon, Hôpital E. Herriot, Service de Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, 69003, Lyon, France.
- University of Lyon 1, CNRS UMR 5305, Lyon, France.
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Ntaios G, Brederecke J, Ojeda FM, Zeller T, Blankenberg S, Schnabel RB. New race-free creatinine- and cystatin C-based equations for the estimation of glomerular filtration rate and association with cardiovascular mortality in the AtheroGene study. Intern Emerg Med 2024; 19:697-703. [PMID: 38351263 PMCID: PMC11039520 DOI: 10.1007/s11739-023-03529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/30/2023] [Indexed: 04/24/2024]
Abstract
Renal function is associated with cardiovascular outcomes and mortality. Among equations used to eGFR, CKD-EPI equations show more accurate association with cardiovascular risk and mortality than MDRD. Recently, new CKD-EPI equations were proposed which do not include race and would be considered sufficiently accurate to estimate eGFR in clinical practice. It is unknown if these new race-free equations are comparably well associated with cardiovascular outcomes in high-risk individuals. The analysis was performed in the AtheroGene Study cohort including patients at high cardiovascular risk. eGFR was determined using the established as well as the recently developed formulas which are calculated without the otherwise existing coefficient for black race. The outcome was cardiovascular death. Analyses included Cox-proportional hazard regression and area-under-the-curve calculation. The analysis included 2089 patients followed up for a median of 3.8 years with a maximum of 6.9 years, corresponding to an overall period of 7701 patient-years. Cardiovascular death occurred in 93 (4.45%), corresponding to an annualized rate of 1.2/100 person-years. In all Cox regression analyses, the estimated adjusted GFR was an independent predictor of cardiovascular death. The equations which included cystatin C showed higher C-index compared to those which did not include cystatin C (0.75-0.76 vs. 0.71, respectively). The equations for the estimation of eGFR which include cystatin C are better associated with cardiovascular death compared to the race-free equations which include only creatinine. This finding adds on the related literature which supports the elimination of race in GFR-estimating equations, and promotion of the use of cystatin C.
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Affiliation(s)
- George Ntaios
- Department of Internal Medicine, School of Health Sciences, University of Thessaly, 41110, Larissa, Greece.
| | - Jan Brederecke
- Department of Cardiology, University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg-Eppendorf, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Francisco M Ojeda
- Department of Cardiology, University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg-Eppendorf, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tanja Zeller
- Department of Cardiology, University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg-Eppendorf, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site, Hamburg, Germany
| | - Stefan Blankenberg
- Department of Cardiology, University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg-Eppendorf, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site, Hamburg, Germany
| | - Renate B Schnabel
- Department of Cardiology, University Center of Cardiovascular Science, University Heart and Vascular Center Hamburg-Eppendorf, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site, Hamburg, Germany
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3
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Pottel H, Nyman U, Björk J, Berg U, Bökenkamp A, Dubourg LD, Lemoine S, Goffin K, Grubb A, Hansson M, Larsson A, Littmann K, Åsling-Monemi K, Adeli K, Cavalier E, Delanaye P. Extending the cystatin C based EKFC-equation to children - validation results from Europe. Pediatr Nephrol 2024; 39:1177-1183. [PMID: 37875730 DOI: 10.1007/s00467-023-06192-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND A new cystatin C based European Kidney Function Consortium (EKFCCysC) equation was recently developed for adults, using the same mathematical form as the previously published full age spectrum creatinine based EKFC-equation (EKFCCrea). In the present study the cystatin C based EKFC-equation is extended to children, by defining the appropriate cystatin C rescaling factor QCysC. METHODS Rescaling factor QCysC for cystatin C was defined as: a) 0.83 mg/L, exactly as it was defined for young adults in the adult equation, and b) a more complex QCysC-age relationship based on 4th degree cystatin C-age polynomials after evaluation of data from Uppsala, Stockholm and Canada and aggregated data from Germany. The EKFCCysC equation was then validated in an independent dataset in European children (n = 2,293) with measured GFR, creatinine, cystatin C, age, height and sex available. RESULTS The EKFCCysC with the simple QCysC-value of 0.83 had a bias of -7.6 [95%CI -8.4;-6.5] mL/min/1.73 m2 and a P30-value of 85.8% [95%CI 84.4;87.3] equal to the EKFCCysC with the more complex 4th degree QCysC-value. The arithmetic mean of the EKFCCrea and EKFCCysC with the simple QCysC of 0.83 had a bias of -4.0 [95%CI -4.5;-3.1] mL/min/1.73 m2 and P30 of 90.4% [95%CI 89.2;91.6] similar to using the more complex 4th degree QCysC-polynomial. CONCLUSION Using exactly the same QCysC of 0.83 mg/L, the adult EKFCCysC can easily be extended to children, with some bias but acceptable P30-values. The arithmetic mean of EKFCCrea and EKFCCysC results in bias closer to zero and P30 slightly over 90%.
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Affiliation(s)
- Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium.
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Ulla Berg
- Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Arend Bökenkamp
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laurence Derain Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, and Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, Université Claude Bernard Lyon 1, Lyon, France
| | - Sandrine Lemoine
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, and Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, Université Claude Bernard Lyon 1, Lyon, France
| | - Karolien Goffin
- Department of Nuclear Medicine, Division of Nuclear Medicine and Molecular Imaging, University Hospital Leuven, KU Leuven, Louvain, Belgium
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
| | - Magnus Hansson
- Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Karin Littmann
- Department of Medicine Huddinge, and Medical Unit of Endocrinology, Theme Inflammation and Ageing, Karolinska Institutet, Stockholm, Sweden, Karolinska University Hospital, Stockholm, Sweden
| | - Kajsa Åsling-Monemi
- Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Khosrow Adeli
- Clinical Biochemistry, Paediatric Laboratory Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart Tilman, Liège, Belgium
| | - Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium
- Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nîmes, France
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Schwaderer AL, Maier P, Greenbaum LA, Furth SL, Schwartz GJ. Application of GFR estimating equations to children with normal, near-normal, or discordant GFR. Pediatr Nephrol 2023; 38:4051-4059. [PMID: 37418011 DOI: 10.1007/s00467-023-06045-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND The objective was to determine the extent that eGFR formulas correspond to measured plasma iohexol clearance (iGFR) in children with normal or near normal kidney function, particularly how different eGFR formulas yield discordant results. METHODS iGFR from 2 (iGFR-2pt) and 4 (iGFR-4pt) time points along with creatinine and/or cystatin C-based eGFR were measured in children with mild CKD, stages 1-2. eGFR was calculated using 6 equations: 3 under 25 (U25) formulas from the Chronic Kidney Disease in Children (CKiD) study, the full age-combined cystatin C (cysC) and creatinine spectrum (FAS-combined), the European Kidney Function Consortium (EKFC-creatinine) equation, and the Chronic Kidney Disease Epidemiology Collaboration (CKD-epi) cysC-based equation. RESULTS Twenty-nine children were included, of which 22 had discordant creatinine vs. cystatin C-based eGFR by ≥ 15mL/min/1.73 m2. Overall, the FAS-combined had the least bias, while the U25 most accurately identified children with an eGFR < 90 mL/min/1.73 m2. When Cr-eGFR was ≥ 15 mL/min higher than CysC-eGFR, the U25 creatinine eGFR was closest to iGFR-4pt. When CysC eGFR was higher, the U25-combined was closest to iGFR-4pt. CONCLUSION The formulas that most closely approximated the measured GFR varied depending on the pattern of discordant eGFR results. Based on the results, we recommend using the CKiD U25-combined formula to screen for children with a low GFR. Either the CKiD U25-combined or FAS-combined would be recommended for changes in eGFR longitudinally. However, because all formulas were discordant from the iGFR-4pt in over a third of participants, further refinement of pediatric eGFR formulas is needed at the normal/near-normal range. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Andrew L Schwaderer
- Department of Pediatrics, Division of Nephrology, Indiana University, Indianapolis, USA
| | - Paula Maier
- Department of Pediatrics, Division of Nephrology, University of Rochester Medical Center, Room 4-8105, 601 Elmwood Avenue, Box 777, Rochester, NY, 14642, USA
| | - Larry A Greenbaum
- Department of Pediatrics, Division of Nephrology, Emory University and Children's Healthcare of Atlanta, Atlanta, USA
| | - Susan L Furth
- Departments of Pediatrics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, and the Children's Hospital of Philadelphia, Philadelphia, USA
| | - George J Schwartz
- Department of Pediatrics, Division of Nephrology, University of Rochester Medical Center, Room 4-8105, 601 Elmwood Avenue, Box 777, Rochester, NY, 14642, USA.
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Smeets NJ, Bökenkamp A, Grubb A, de Wildt SN, Schreuder MF. Cystatin C as a Marker for Glomerular Filtration Rate in Critically Ill Neonates and Children: Validation Against Iohexol Plasma Clearance. Kidney Int Rep 2023; 8:1672-1675. [PMID: 37547520 PMCID: PMC10403645 DOI: 10.1016/j.ekir.2023.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/27/2023] [Accepted: 05/26/2023] [Indexed: 08/08/2023] Open
Affiliation(s)
- Nori J.L. Smeets
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Intensive Care and Department of Pediatric Surgery, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - A. Bökenkamp
- Department of Pediatric Nephrology, Emma Children’s Hospital, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Anders Grubb
- Department of Clinical Chemistry and Pharmacology, Laboratory Medicine, Lund University, Lund, Sweden
| | - Saskia N. de Wildt
- Department of Pharmacology and Toxicology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Intensive Care and Department of Pediatric Surgery, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands
| | - Michiel F. Schreuder
- Division of Pediatric Nephrology, Department of Pediatrics, Radboud University Medical Center, Amalia Children’s Hospital, Nijmegen, The Netherlands
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Pottel H, Björk J, Rule AD, Ebert N, Eriksen BO, Dubourg L, Vidal-Petiot E, Grubb A, Hansson M, Lamb EJ, Littmann K, Mariat C, Melsom T, Schaeffner E, Sundin PO, Åkesson A, Larsson A, Cavalier E, Bukabau JB, Sumaili EK, Yayo E, Monnet D, Flamant M, Nyman U, Delanaye P. Cystatin C-Based Equation to Estimate GFR without the Inclusion of Race and Sex. N Engl J Med 2023; 388:333-343. [PMID: 36720134 DOI: 10.1056/nejmoa2203769] [Citation(s) in RCA: 62] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The accuracy of estimation of kidney function with the use of routine metabolic tests, such as measurement of the serum creatinine level, has been controversial. The European Kidney Function Consortium (EKFC) developed a creatinine-based equation (EKFC eGFRcr) to estimate the glomerular filtration rate (GFR) with a rescaled serum creatinine level (i.e., the serum creatinine level is divided by the median serum creatinine level among healthy persons to control for variation related to differences in age, sex, or race). Whether a cystatin C-based EKFC equation would increase the accuracy of estimated GFR is unknown. METHODS We used data from patients in Sweden to estimate the rescaling factor for the cystatin C level in adults. We then replaced rescaled serum creatinine in the EKFC eGFRcr equation with rescaled cystatin C, and we validated the resulting EKFC eGFRcys equation in cohorts of White patients and Black patients in Europe, the United States, and Africa, according to measured GFR, levels of serum creatinine and cystatin C, age, and sex. RESULTS On the basis of data from 227,643 patients in Sweden, the rescaling factor for cystatin C was estimated at 0.83 for men and women younger than 50 years of age and 0.83 + 0.005 × (age - 50) for those 50 years of age or older. The EKFC eGFRcys equation was unbiased, had accuracy that was similar to that of the EKFC eGFRcr equation in both White patients and Black patients (11,231 patients from Europe, 1093 from the United States, and 508 from Africa), and was more accurate than the Chronic Kidney Disease Epidemiology Collaboration eGFRcys equation recommended by Kidney Disease: Improving Global Outcomes. The arithmetic mean of EKFC eGFRcr and EKFC eGFRcys further improved the accuracy of estimated GFR over estimates from either biomarker equation alone. CONCLUSIONS The EKFC eGFRcys equation had the same mathematical form as the EKFC eGFRcr equation, but it had a scaling factor for cystatin C that did not differ according to race or sex. In cohorts from Europe, the United States, and Africa, this equation improved the accuracy of GFR assessment over that of commonly used equations. (Funded by the Swedish Research Council.).
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Affiliation(s)
- Hans Pottel
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Jonas Björk
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Andrew D Rule
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Natalie Ebert
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Björn O Eriksen
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Laurence Dubourg
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Emmanuelle Vidal-Petiot
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Anders Grubb
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Magnus Hansson
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Edmund J Lamb
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Karin Littmann
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Christophe Mariat
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Toralf Melsom
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Elke Schaeffner
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Per-Ola Sundin
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Anna Åkesson
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Anders Larsson
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Etienne Cavalier
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Justine B Bukabau
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Ernest K Sumaili
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Eric Yayo
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Dagui Monnet
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Martin Flamant
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Ulf Nyman
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
| | - Pierre Delanaye
- From the Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk (H.P.), and the Departments of Clinical Chemistry (E.C.) and Nephrology-Dialysis-Transplantation (P.D.), University of Liège, Centre Hospitalier Universitaire du Sart-Tilman, Liège - all in Belgium; the Division of Occupational and Environmental Medicine, Lund University (J.B., A.Å.), Clinical Studies Sweden, Forum South (J.B., A.Å.), and the Department of Clinical Chemistry (A.G.), Skåne University Hospital, Lund, the Function Area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, and Department of Laboratory Medicine, Stockholm (M.H.), the Division of Clinical Chemistry, Huddinge (K.L.), the Department of Geriatrics, School Department of Laboratory Medicine, Karolinska Institutet of Medical Sciences, Örebro University, Örebro (P.-O.S.), the Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala (A.L.), and the Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö (U.N.) - all in Sweden; the Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (A.D.R.); Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.); the Section of Nephrology, University Hospital of North Norway and Metabolic and Renal Research Group, Universitetet i Tromsø the Arctic University of Norway, Tromsø, Norway (B.O.E., T.M.); Service de Néphrologie, Dialyse, Hypertension et Explorations Fonctionnelles Rénales, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon (L.D.), Assistance Publique-Hôpitaux de Paris (AP-HP), Bichat Hospital, and Université de Paris, INSERM Unité 1149 (E.V.-P.), and AP-HP, Bichat Hospital, and Université de Paris, Unité Mixte de Recherche S1138, Cordeliers Research Center (M.F.), Paris, Service de Néphrologie, Dialyse et Transplantations Rénales, Hôpital Nord, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne (C.M.), and the Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes (P.D.) - all in France; Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.); the Renal Unit, Department of Internal Medicine, Kinshasa University Hospital, University of Kinshasa, Kinshasa, Democratic Republic of Congo (J.B.B., E.K.S.); and the Département de Biochimie, Unité de Formation et de Recherche Sciences Pharmaceutiques et Biologiques, Université Felix Houphouët Boigny, Abidjan, Ivory Coast (E.Y., D.M.)
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7
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Zheng WH, Zhu YB, Yao Y, Huang HB. Serum creatinine/cystatin C ratio as a muscle mass evaluating tool and prognostic indicator for hospitalized patients: A meta-analysis. Front Med (Lausanne) 2023; 9:1058464. [PMID: 36698829 PMCID: PMC9868859 DOI: 10.3389/fmed.2022.1058464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Objective Sarcopenia is a syndrome of decreased muscle mass and deficits in muscle strength and physical function. We aimed to investigate the relationship between creatinine/cystatin C ratio (CCR) and sarcopenia and the prognostic value of CCR in hospitalized patients. Materials and methods We searched for relevant studies in PubMed, EMBASE, and the Cochrane Database up to August 25, 2022. Meta-analyses were performed to evaluate the relationship between CCR and skeletal muscle [computed tomography-assessed skeletal muscle (CTASM), muscle strength, and physical performance], prognosis and important clinical outcomes in hospitalized adults. The pooled correlation coefficient, the area under the receiver operating characteristic (ROC) curves, and hazard ratio (HR) together with their 95% confidence intervals (CIs) were calculated. We also conducted subgroup analyses to explore the sources of heterogeneity. Results A total of 38 studies with 20,362 patients were eligible. These studies were of moderate to high quality. Our results showed that CCR was significant correlations with all CTASM types (Fisher's Z ranged from 0.35 to 0.5; P values ranged from < 0.01 to 0.01), handgrip strength (Fisher's Z = 0.39; 95% CI, 0.32-0.45; P < 0.001) and gait speed (Fisher's Z = 0.25; 95% CI, 0.21-0.30; P < 0.001). The ROC curves suggested that CCR had good diagnostic efficacy (0.689; 95% CI, 0.632-0.746; P < 0.01) for sarcopenia. CCR can reliably predict mortality in hospitalized patients, which was confirmed by regression analysis of CCR as both continuous (HR 0.78; 95% CI, 0.72-0.84; P < 0.01) and categorical variables (HR 2.05; 95% CI, 1.58-2.66; P < 0.0001). In addition, less evidence showed that higher CCR was independently associated with a shorter duration of mechanical ventilation, reduced length of stay in the intensive care unit and hospital, less nutritional risk, and decreased complications in hospitalized patients. Conclusion CCR could be a simple, economical, and effective screening tool for sarcopenia in hospitalized patients, and it is a helpful prognostic factor for mortality and other important clinical outcomes. Systematic review registration https://inplasy.com/inplasy-2022-9-0097/, identifier INPLASY202290097.
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Affiliation(s)
- Wen-He Zheng
- Department of Critical Care Medicine, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yi-Bing Zhu
- Department of Critical Care Medicine, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Yao
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Hui-Bin Huang
- Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China,*Correspondence: Hui-Bin Huang,
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8
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Tang Y, Hou L, Sun T, Li S, Cheng J, Xue D, Wang X, Du Y. Improved equations to estimate GFR in Chinese children with chronic kidney disease. Pediatr Nephrol 2023; 38:237-247. [PMID: 35467153 DOI: 10.1007/s00467-022-05552-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND There is currently no specific equation for estimating glomerular filtration rate (GFR) in Chinese children with chronic kidney disease (CKD). The commonly used equations are less robust than expected; we therefore sought to derive more appropriate equations for GFR estimation. METHODS A total of 751 Chinese children with CKD were divided into 2 groups, training group (n = 501) and validation group (n = 250). In the training group, a univariate linear regression model was used to calculate predictability of variables associated with GFR. Residuals were compared to determine multivariate predictability of GFR in the equation. Standard regression techniques for Gaussian data were used to determine coefficients of GFR-estimating equations after logarithmic transformation of measured GFR (iGFR), height/serum creatinine (height/Scr), cystatin C, blood urea nitrogen (BUN), and height. These were compared with other well-known equations using the validation group. RESULTS Median 99mTc-DTPA GFR was 90.1 (interquartile range: 67.3-108.6) mL/min/1.73 m2 in training dataset. Our CKD equation, eGFR (mL/min/1.73 m2) = 91.021 [height(m)/Scr(mg/dL)/2.7]0.443 [1.2/Cystatin C(mg/L)]0.335 [13.7/BUN (mg/dL)]-0.095 [ 0.991male] [height(m)/1.4]0.275, was derived. This was further tested in the validation group, with percentages of eGFR values within 30% and 15% of iGFR (P30 and P15) of 76.00% and 48.40%, respectively. For centres with no access to cystatin C, a creatinine-based equation, eGFR (mL/min/1.73 m2) = 89.674 [height(m)/Scr(mg/dL)/2.7]0.579 [ 1.007male] [height(m)/1.4]0.187, was derived, with P30 and P15 73.60% and 49.20%, respectively. These were significantly higher compared to other well-known equations (p < 0.05). CONCLUSION We developed equations for GFR estimation in Chinese children with CKD based on Scr, BUN and cystatin C. These are more accurate than commonly used equations in this population.
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Affiliation(s)
- Ying Tang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ling Hou
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tingting Sun
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shanping Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Junli Cheng
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dan Xue
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiuli Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Du
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.
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den Bakker E, Bökenkamp A, Haffner D. Assessment of Kidney Function in Children. Pediatr Clin North Am 2022; 69:1017-1035. [PMID: 36880920 DOI: 10.1016/j.pcl.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A good understanding of kidney function tests is essential for patient care. Urinalysis is the commonest used test for screening purposes in ambulatory settings. Glomerular function is assessed further by urine protein excretion and estimated glomerular filtration rate and tubular function by various tests such as urine anion gap and excretion of sodium, calcium, and phosphate. In addition, kidney biopsy and/or genetic analyses may be required to further characterize the underlying kidney disease. In this article, we discuss maturation and the assessment of kidney function in children.
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Affiliation(s)
- Emil den Bakker
- Department of Pediatrics, Emma Children's Hospital, Amsterdam University Medical Centers, Meibergdreef 9, Amsterdam NL-1105 AZ, the Netherlands
| | - Arend Bökenkamp
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam University Medical Centers, Meibergdreef 9, Amsterdam NL-1105 AZ, the Netherlands
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, Hannover 30625, Germany.
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Nyman U, Björk J, Berg U, Bökenkamp A, Dubourg L, Goffin K, Grubb A, Hansson M, Larsson A, Littmann K, Åsling-Monemi K, Pottel H, Delanaye P. The Modified CKiD Study Estimated GFR Equations for Children and Young Adults Under 25 Years of Age: Performance in a European Multicenter Cohort. Am J Kidney Dis 2022; 80:807-810. [PMID: 35346743 DOI: 10.1053/j.ajkd.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 02/07/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden.
| | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden.
| | - Ulla Berg
- Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Arend Bökenkamp
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, and Laboratory of Tissue Biology and Therapeutic Engineering, UMR 5305 CNRS, Université Claude Bernard Lyon 1, Lyon, France
| | - Karolien Goffin
- Department of Nuclear Medicine, University Hospital Leuven, Division of Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
| | - Magnus Hansson
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge and Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Karin Littmann
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden and Medical Unit of Endocrinology, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Kajsa Åsling-Monemi
- Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium; Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nimes, France
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11
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Fetal growth restriction followed by very preterm birth is associated with smaller kidneys but preserved kidney function in adolescence. Pediatr Nephrol 2022; 38:1855-1866. [PMID: 36409369 PMCID: PMC10154253 DOI: 10.1007/s00467-022-05785-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/02/2022] [Accepted: 10/06/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Preterm birth and fetal growth restriction (FGR) are associated with structural and functional kidney changes, increasing long-term risk for chronic kidney disease and hypertension. However, recent studies in preterm children are conflicting, indicating structural changes but normal kidney function. This study therefore assessed kidney structure and function in a cohort of adolescents born very preterm with and without verified FGR. METHODS Adolescents born very preterm with FGR and two groups with appropriate birthweight (AGA) were included; one matched for gestational week at birth and one born at term. Cortical and medullary kidney volumes and T1 and T2* mapping values were assessed by magnetic resonance imaging. Biochemical markers of kidney function and renin-angiotensin-aldosterone system (RAAS) activation were analyzed. RESULTS Sixty-four adolescents were included (13-16 years; 48% girls). Very preterm birth with FGR showed smaller total (66 vs. 75 ml/m2; p = 0.01) and medullary volume (19 vs. 24 ml/m2; p < 0.0001) compared to term AGA. Corticomedullary volume ratio decreased from preterm FGR (2.4) to preterm AGA (2.2) to term AGA (1.9; p = 0.004). There were no differences in T1 or T2* values (all p ≥ 0.34) or in biochemical markers (all p ≥ 0.12) between groups. CONCLUSIONS FGR with abnormal fetal blood flow followed by very preterm birth is associated with smaller total kidney and medullary kidney volumes, but not with markers of kidney dysfunction or RAAS activation in adolescence. Decreased total kidney and medullary volumes may still precede a long-term decrease in kidney function, and potentially be used as a prognostic marker. A higher resolution version of the Graphical abstract is available as Supplementary information.
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12
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de Simone G, Mancusi C, Hanssen H, Genovesi S, Lurbe E, Parati G, Sendzikaite S, Valerio G, Di Bonito P, Di Salvo G, Ferrini M, Leeson P, Moons P, Weismann CG, Williams B. Hypertension in children and adolescents. Eur Heart J 2022; 43:3290-3301. [PMID: 35896123 DOI: 10.1093/eurheartj/ehac328] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 05/11/2022] [Accepted: 06/07/2022] [Indexed: 12/12/2022] Open
Abstract
Definition and management of arterial hypertension in children and adolescents are uncertain, due to different positions of current guidelines. The European Society of Cardiology task-force, constituted by Associations and Councils with interest in arterial hypertension, has reviewed current literature and evidence, to produce a Consensus Document focused on aspects of hypertension in the age range of 6-16 years, including definition, methods of measurement of blood pressure, clinical evaluation, assessment of hypertension-mediated target organ damage, evaluation of possible vascular, renal and hormonal causes, assessment and management of concomitant risk factors with specific attention for obesity, and anti-hypertensive strategies, especially focused on life-style modifications. The Consensus Panel also suggests aspects that should be studied with high priority, including generation of multi-ethnic sex, age and height specific European normative tables, implementation of randomized clinical trials on different diagnostic and therapeutic aspects, and long-term cohort studies to link with adult cardiovascular risk. Finally, suggestions for the successful implementation of the contents of the present Consensus document are also given.
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Affiliation(s)
- Giovanni de Simone
- Hypertension Research Center & Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Costantino Mancusi
- Hypertension Research Center & Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Simonetta Genovesi
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital & School of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
| | - Empar Lurbe
- Paediatric Department, Consorcio Hospital General, University of Valencia; CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, San Luca Hospital & School of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
| | - Skaiste Sendzikaite
- Clinic of Paediatrics, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, 'S.Maria delle Grazie' Hospital, Pozzuoli, Italy
| | - Giovanni Di Salvo
- Paediatric Cardiology Unit, Department of Woman's and Child's Health, University-Hospital of Padova, University of Padua, Padua, Italy
| | - Marc Ferrini
- St Joseph and St Luc Hospital Department of Cardiology and Vascular Pathology, Lyon, France
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, RDM Division of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven, Belgium & Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Constance G Weismann
- Paediatric Heart Center, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London, and NIHR University College London Hospitals Biomedical Research Centre, London, UK
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13
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Bíró E, Szegedi I, Kiss C, Oláh AV, Dockrell M, Price RG, Szabó T. The role of urinary N-acetyl-β-D-glucosaminidase in early detection of acute kidney injury among pediatric patients with neoplastic disorders in a retrospective study. BMC Pediatr 2022; 22:429. [PMID: 35854249 PMCID: PMC9297588 DOI: 10.1186/s12887-022-03416-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 06/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background The 1-year cumulative incidence of AKI reportedly is high (52%) in pediatric neoplastic disorders. About half of these events occur within 2 weeks. However, subclinical AKI episodes may remain unrecognized by the conventional creatinine-based approaches. We investigated the diagnostic value of urinary N-acetyl-β-D-glucosaminidase (uNAG) as an early marker of acute kidney injury (AKI). Methods In our retrospective study, 33 children with neoplastic disorders were inculded who had serial uNAG tests (at least 5 samples/patient) with a total of 367 uNAG measurements. Renal function was determined by cystatin-C and creatinine based GFR, and relative increase of uNAG index (uNAGRI). We focused on detecting both clinical and subclinical AKI episodes (according to Biomarker-Guided Risk Assessment using pRIFLE criteria and /or elevated uNAG levels) and the incidence of chronic kidney damage. Results Sixty episodes in 26 patients, with positivity at least in one parameter of kidney panel, were identified during the observation period. We detected 18/60 clinical and 12/60 subclinical renal episodes. In 27/60 episodes only uNAG values was elevated with no therapeutic consequence at presentation. Two patients were detected with decreased initial creatinine levels with 3 „silent” AKI. In 13 patients, modest elevation of uNAG persisted suggesting mild, reversible tubular damage, while chronic tubuloglomerular injury occurred in 5 patients. Based on ROC analysis for the occurence of AKI, uNAGRI significantly indicated the presence of AKI, the sensitivity and specificity are higher than the changes of GFRCreat. Serial uNAG measurements are recommended for the reduction of the great amount of false positive uNAG results, often due to overhydratation. Conclusion Use of Biomarker-guided Risk Assessment for AKI identified 1.5 × more clinical and subclinical AKI episodes than with creatinine alone in our pediatric cancer patients. Based on the ROC curve for the occurence of AKI, uNAGRI has relatively high sensitivity and specificity comparable to changes of GFRCysC. The advantage of serial uNAG measurements is to decrease the number of false positive results. Trial registration The consent to participate is not applicable because it was not reqired for ethical approval and it is a retrospectiv study. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03416-w.
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Affiliation(s)
- Erika Bíró
- Department of Pediatrics, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, 4028, Debrecen, Hungary
| | - István Szegedi
- Department of Pediatrics, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, 4028, Debrecen, Hungary
| | - Csongor Kiss
- Department of Pediatrics, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, 4028, Debrecen, Hungary
| | - Anna V Oláh
- Department of Laboratory Medicine, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, 4028, Debrecen, Hungary
| | - Mark Dockrell
- SWT Institute for Renal Research, Epsom and St Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton, SM5 1AA, London, United Kingdom
| | - Robert G Price
- King's College London, Stamford Street, SE1 9NH, London, United Kingdom
| | - Tamás Szabó
- Department of Pediatrics, University of Debrecen, Faculty of Medicine, Nagyerdei krt 98, 4028, Debrecen, Hungary.
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Di Bonito P, Rosanio FM, Marcovecchio ML, Cherubini V, Delvecchio M, Di Candia F, Iafusco D, Zanfardino A, Iovane B, Maffeis C, Maltoni G, Ripoli C, Piccinno E, Piona CA, Ricciardi MR, Schiaffini R, Franzese A, Mozzillo E. Uric acid and cardiometabolic risk by gender in youth with type 1 diabetes. Sci Rep 2022; 12:12153. [PMID: 35840585 PMCID: PMC9287370 DOI: 10.1038/s41598-022-15484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/24/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to investigate the association between uric acid (UA) and cardiometabolic risk factors (CMRFs) by sex in youth with type 1 diabetes (T1D). Retrospective data collected from 1323 children and adolescents (5–18 years; 716 boys) with T1D recruited in 9 Italian Pediatric Diabetes Centers were analyzed. CMRFs included UA, HbA1c, blood pressure (BP), cholesterol (TC), HDL, triglycerides (TG), neutrophils (N) and lymphocytes (L) count, glomerular filtration rate (eGFR) (calculated using Schwartz-Lyon equation). In boys, we found a higher age, daily insulin dose, TG, TG/HDL ratio, TC/HDL ratio, systolic BP, N/L ratio and lower HDL, and eGFR across UA tertiles (p = 0.01–0.0001). Similar results were found in girls but not for TG and systolic BP. In boys, the odds ratio (OR) of high levels of TG/HDL ratio, TC/HDL ratio, BP and mildly reduced eGFR (MRGFR) increased for 0.5 mg/dL of UA. Instead, in girls an increased levels of 0.5 mg/dL of UA were associated with high OR of TC/HDL ratio, N/L ratio and MRGFR. Uric acid may represent a useful marker for identifying youth with T1D at high cardiometabolic risk, and this association appears to vary by sex.
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Affiliation(s)
- Procolo Di Bonito
- Department of Internal Medicine, "S. Maria Delle Grazie", Pozzuoli Hospital, Naples, Italy
| | - Francesco Maria Rosanio
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | | | - Valentino Cherubini
- Department of Women's and Children's Health, Azienda Ospedaliero-Universitaria, Ospedale Riuniti Di Ancona, "G. Salesi" Hospital, Ancona, Italy
| | - Maurizio Delvecchio
- Azienda Ospedaliero Universitaria Consorziale Policlinico Giovanni XXIII, Bari, Italy
| | - Francesca Di Candia
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Angela Zanfardino
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Brunella Iovane
- Regional Diabetes Center, Children Hospital "Pietro Barilla", University Hospital of Parma, Parma, Italy
| | - Claudio Maffeis
- Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Giulio Maltoni
- Department of Woman, Child and Urological Diseases, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Carlo Ripoli
- Pediatric Diabetology Unit, Pediatric and Microcytemia Department, AO Brotzu, Cagliari, Italy
| | - Elvira Piccinno
- Azienda Ospedaliero Universitaria Consorziale Policlinico Giovanni XXIII, Bari, Italy
| | - Claudia Anita Piona
- Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | | | | | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center for Pediatric Diabetes, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy.
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Raina R, Abu-Arja R, Sethi S, Dua R, Chakraborty R, Dibb JT, Basu RK, Bissler J, Felix MB, Brophy P, Bunchman T, Alhasan K, Haffner D, Kim YH, Licht C, McCulloch M, Menon S, Onder AM, Khooblall P, Khooblall A, Polishchuk V, Rangarajan H, Sultana A, Kashtan C. Acute kidney injury in pediatric hematopoietic cell transplantation: critical appraisal and consensus. Pediatr Nephrol 2022; 37:1179-1203. [PMID: 35224659 DOI: 10.1007/s00467-022-05448-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 12/15/2022]
Abstract
Hematopoietic cell transplantation (HCT) is a common therapy for the treatment of neoplastic and metabolic disorders, hematological diseases, and fatal immunological deficiencies. HCT can be subcategorized as autologous or allogeneic, with each modality being associated with their own benefits, risks, and post-transplant complications. One of the most common complications includes acute kidney injury (AKI). However, diagnosing HCT patients with AKI early on remains quite difficult. Therefore, this evidence-based guideline, compiled by the Pediatric Continuous Renal Replacement Therapy (PCRRT) working group, presents the various factors that contribute to AKI and recommendations regarding optimization of therapy with minimal complications in HCT patients.
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Affiliation(s)
- Rupesh Raina
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA.
- Department of Nephrology, Akron Children's Hospital, Akron, OH, USA.
| | - Rolla Abu-Arja
- Division of Hematology, Oncology, Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sidharth Sethi
- Pediatric Nephrology, Kidney Institute, Medanta, The Medicity Hospital, Gurgaon, Haryana, India
| | - Richa Dua
- Monmouth Medical Center, Long Branch, NJ, USA
| | - Ronith Chakraborty
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA
| | - James T Dibb
- Department of Internal Medicine, Summa Health System - Akron Campus, Akron, OH, USA
| | - Rajit K Basu
- Children's Healthcare of Atlanta, Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - John Bissler
- Department of Pediatrics, University of Tennessee Health Science Center and Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Melvin Bonilla Felix
- Department of Pediatrics, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
| | - Patrick Brophy
- Department of Pediatrics, University of Rochester School of Medicine, Rochester, NY, USA
| | - Timothy Bunchman
- Pediatric Nephrology & Transplantation, Children's Hospital of Richmond at VCU, Richmond, VA, USA
| | - Khalid Alhasan
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Dieter Haffner
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Yap Hui Kim
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore
| | - Christopher Licht
- Division of Nephrology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Mignon McCulloch
- Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Shina Menon
- Division of Pediatric Nephrology, Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Ali Mirza Onder
- Division of Pediatric Nephrology, Le Bonheur Children's Hospital, University of Tennessee, School of Medicine, Memphis, TN, USA
- Division of Pediatric Nephrology, Batson Children's Hospital of Mississippi, University of Mississippi Medical Center, Jackson, MS, USA
| | - Prajit Khooblall
- Department of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Amrit Khooblall
- Akron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA
| | - Veronika Polishchuk
- Division of Hematology, Oncology, Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Hemalatha Rangarajan
- Division of Hematology, Oncology, Blood and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Azmeri Sultana
- Department of Pediatric Nephrology, MR Khan Hospital & Institute of Child Health, Mirpur-2, Dhaka, Bangladesh
| | - Clifford Kashtan
- Department of Pediatrics, Division of Pediatric Nephrology, University of Minnesota Medical School, Minneapolis, MN, USA
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Skogastierna C, Elfvin A, Hansson S, Magnusson P, Swolin‐Eide D. Impaired renal clearance among Swedish adolescents born preterm. Acta Paediatr 2022; 111:1722-1728. [PMID: 35490381 PMCID: PMC9545013 DOI: 10.1111/apa.16379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 12/24/2022]
Abstract
AIM To determine whether adolescents born before 28 gestational weeks have an increased risk for renal impairment. METHODS Swedish infants, born before 28 gestational weeks in 2001 and 2002, were identified from a local register. A total of 16 children, 12 females and 4 males, were examined at 16-17 years of age with 51 Cr-EDTA clearance. A comparison group (n = 26) was used. RESULTS Most study participants (n = 13) had normal blood pressure; one individual had hypertension stage 1. All study participants had results within the reference interval for ionised calcium, parathyroid hormone, intact fibroblast growth factor-23 and for urinary albumin-to-creatinine ratio. Four out of 16 participants (25%) had a 51 Cr-EDTA clearance less than 90 ml/min/1.73 m2 , indicating a reduced kidney function. Measured 51 Cr-EDTA clearance values were significantly lower in the study group than in the comparison group (p = 0.0012). Five study participants (31%) were referred for further investigations. CONCLUSION Swedish children born before 28 gestational weeks have an increased risk of renal impairment later in life, suggesting that the kidney function in these individuals should be assessed, at least once, during adolescence.
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Affiliation(s)
- Carin Skogastierna
- Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Anders Elfvin
- Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatrics Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
| | - Sverker Hansson
- Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Per Magnusson
- Department of Clinical Chemistry Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden
| | - Diana Swolin‐Eide
- Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatrics Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
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Li Z, Huang Y, Xu H, Li Z. Population pharmacokinetic and dose optimization of mycophenolic acid in children with anti-neutrophilic cytoplasmic antibody-associated nephritis. Eur J Clin Pharmacol 2022; 78:831-838. [DOI: 10.1007/s00228-021-03265-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/11/2021] [Indexed: 11/03/2022]
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Ziegelasch N, Vogel M, Körner A, Koch E, Jurkutat A, Ceglarek U, Dittrich K, Kiess W. Cystatin C relates to metabolism in healthy, pubertal adolescents. Pediatr Nephrol 2022; 37:423-432. [PMID: 34432142 PMCID: PMC8816513 DOI: 10.1007/s00467-021-05209-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/05/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The cystatin C (CysC) serum level is a marker of glomerular filtration rate and depends on age, gender, and pubertal stage. We hypothesize that CysC might overall reflect energy homeostasis and be regulated by components of the endocrine system and metabolites in pubertal adolescents. METHODS Serum CysC levels and further possible effector parameters in 5355 fasting, morning venous blood samples from 2035 healthy participants of the LIFE Child cohort study (age 8 to 18 years) were analyzed. Recruitment started in 2011, with probands followed up once a year. Linear univariate and stepwise multivariate regression analyses were performed. RESULTS Annual growth rate, serum levels of thyroid hormones, parathyroid hormone, insulin-like growth factor 1, hemoglobin A1c (HbA1c), uric acid, and alkaline phosphatase show relevant and significant associations with CysC serum concentrations (p <0.001). Furthermore, male probands' CysC correlated with the body mass index and testosterone among other sexual hormones. Multivariate analyses revealed that uric acid and HbA1c are associated variables of CysC independent from gender (p <0.001). In males, alkaline phosphatase (p <0.001) is additionally significantly associated with CysC. Thyroid hormones show significant correlations only in multivariate analyses in females (p <0.001). CONCLUSIONS The described associations strongly suggest an impact of children's metabolism on CysC serum levels. These alterations need to be considered in kidney diagnostics using CysC in adolescents. Additionally, further studies are needed on CysC in children.
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Affiliation(s)
- Niels Ziegelasch
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103, Leipzig, Germany.
| | - Mandy Vogel
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany
| | - Antje Körner
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,Centre of Paediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
| | - Eva Koch
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany
| | - Anne Jurkutat
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany
| | - Uta Ceglarek
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostic (ILM), University Hospital Leipzig, 04103 Leipzig, Germany
| | - Katalin Dittrich
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,Centre of Paediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany ,Present Address: DSO, Walter-Koehn-Str. 1a, Organisationszentrale, D-04356 Leipzig, Germany
| | - Wieland Kiess
- Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 27b, 04103 Leipzig, Germany ,LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Philipp-Rosenthalstrasse 27, 04103 Leipzig, Germany ,Centre of Paediatric Research (CPL), University of Leipzig, 04103 Leipzig, Germany
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Soeorg H, Noortoots A, Karu M, Saks K, Lass J, Lutsar I, Kõrgvee LT. Glomerular filtration rate in children and young adults with haemato-oncological disease and infection is best described by three-compartment iohexol model. Pediatr Blood Cancer 2022; 69:e29305. [PMID: 34472203 DOI: 10.1002/pbc.29305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Children with cancer and infection may develop glomerular hyperfiltration. With the aim to determine the prevalence of glomerular hyperfiltration in children and young adults with haemato-oncological disease and infection, we developed population pharmacokinetic model of iohexol. We further aimed to assess the accuracy of estimated glomerular filtration rate (eGFR) equations and single- or two-point measured GFR (mGFR) formulas compared with GFR based on iohexol clearance from our population pharmacokinetic model (iGFR). PROCEDURE Hospitalised patients (0.5-25 years) with haemato-oncological disease and infection were included if their eGFR was ≥80 ml/min/1.73 m2 at the screening visit. Iohexol plasma concentrations were described by population pharmacokinetic model. Bias, precision and accuracy of 23 eGFR equations and 18 mGFR formulas were calculated. RESULTS Total of 32 iohexol administrations were performed in 28 patients. Median (range) eGFR was 136 ml/min/1.73 m2 (74-234) and age 15.1 years (0.8-26.0). Three-compartment model with allometric scaling of central, one peripheral compartment and clearance (with power 0.75) to weight fitted the best. Median (range) iGFR was 103 ml/min/1.73 m2 (68-140). All except one eGFR equation overestimated GFR. Lund-Malmö revised eGFR equation performed the best, followed by Gao equation. Of single- or two-point mGFR formulas, 15 overestimated iGFR. Modified Jacobsson formula at 5.5 hours performed the best, followed by Fleming formula at 3 hours. CONCLUSIONS In children and young adults with haemato-oncological disease and infection, renal function is best described by iohexol clearance from three-compartment pharmacokinetic model, while eGFR equations and single- and two-point mGFR formulas overestimate iGFR.
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Affiliation(s)
- Hiie Soeorg
- Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Aveli Noortoots
- Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Maarja Karu
- Department of Haematology and Oncology, Clinic of Paediatrics, Tallinn Children's Hospital, Tallinn, Estonia
| | - Kadri Saks
- Department of Haematology and Oncology, Clinic of Paediatrics, Tallinn Children's Hospital, Tallinn, Estonia
| | - Jana Lass
- Pharmacy Department, Tartu University Hospital, Tartu, Estonia
| | - Irja Lutsar
- Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Lenne-Triin Kõrgvee
- Department of Pharmacology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia.,Haematology and Oncology Clinic, Tartu University Hospital, Tartu, Estonia
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20
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Abstract
Pediatric hemodialysis access is a demanding field. Procedures are infrequent, technically challenging, and associated with high complication and failure rates. Each procedure affects subsequent access and transplants sites. The choice is made easier and outcomes improved when access decisions are made by a multidisciplinary, pediatric, hemodialysis access team. This manuscript reviews the current literature and offers technical suggestions to improve outcomes.
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21
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van de Velde ME, den Bakker E, Blufpand HN, Kaspers GL, Abbink FCH, Kors AWA, Wilhelm AJ, Honeywell RJ, Peters GJ, Stoffel-Wagner B, Buffart LM, Bökenkamp A. Carboplatin Dosing in Children Using Estimated Glomerular Filtration Rate: Equation Matters. Cancers (Basel) 2021; 13:cancers13235963. [PMID: 34885072 PMCID: PMC8656997 DOI: 10.3390/cancers13235963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Renal function-based carboplatin dosing using measured glomerular filtration rate (GFR) results in more consistent drug exposure than anthropometric dosing. We aimed to validate the Newell dosing equation using estimated GFR (eGFR) and study which equation most accurately predicts carboplatin clearance in children with retinoblastoma. In 13 children with retinoblastoma 38 carboplatin clearance values were obtained from individual fits using MWPharm++. Carboplatin exposure (AUC) was calculated from administered dose and observed carboplatin clearance and compared to predicted AUC calculated with a carboplatin dosing equation (Newell) using different GFR estimates. Different dosing regimens were compared in terms of accuracy, bias and precision. All patients had normal eGFR. Carboplatin exposure using cystatin C-based eGFR equations tended to be more accurate compared to creatinine-based eGFR (30% accuracy 76.3-89.5% versus 76.3-78.9%, respectively), which led to significant overexposure, especially in younger (aged ≤ 2 years) children. Of all equations, the Schwartz cystatin C-based equation had the highest accuracy and lowest bias. Although anthropometric dosing performed comparably to many of the eGFR equations overall, we observed a weight-dependent change in bias leading to underdosing in the smallest patients. Using cystatin C-based eGFR equations for carboplatin dosing in children leads to more accurate carboplatin-exposure in patients with normal renal function compared to anthropometric dosing. In children with impaired kidney function, this trend might be more pronounced. Anthropometric dosing is hampered by a weight-dependent bias.
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Affiliation(s)
- Mirjam E. van de Velde
- Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, 1081 HV Amsterdam, The Netherlands; (H.N.B.); (A.W.A.K.); (G.L.K.)
- Department of Pediatric Oncology/Hematology, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-(0)20-444-6206; Fax: +31-(0)20-444-5122
| | - Emil den Bakker
- Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Nephrology, 1081 HV Amsterdam, The Netherlands; (E.d.B.); (A.B.)
| | - Hester N. Blufpand
- Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, 1081 HV Amsterdam, The Netherlands; (H.N.B.); (A.W.A.K.); (G.L.K.)
| | - Gertjan L. Kaspers
- Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, 1081 HV Amsterdam, The Netherlands; (H.N.B.); (A.W.A.K.); (G.L.K.)
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Floor C. H. Abbink
- Emma Children’s Hospital, Amsterdam UMC, Amsterdam Medical Center, Pediatric Oncology, 1081 HV Amsterdam, The Netherlands;
| | - Arjenne W. A. Kors
- Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Oncology, 1081 HV Amsterdam, The Netherlands; (H.N.B.); (A.W.A.K.); (G.L.K.)
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Abraham J. Wilhelm
- Amsterdam UMC, Vrije Universiteit Amsterdam, Clinical Pharmacology and Pharmacy, 1081 HV Amsterdam, The Netherlands;
| | - Richard J. Honeywell
- Laboratory of Medical Oncology, Amsterdam University Medical Center, VUMC, 1081 HV Amsterdam, The Netherlands; (R.J.H.); (G.J.P.)
| | - Godefridus J. Peters
- Laboratory of Medical Oncology, Amsterdam University Medical Center, VUMC, 1081 HV Amsterdam, The Netherlands; (R.J.H.); (G.J.P.)
- Department of Biochemistry, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Birgit Stoffel-Wagner
- Institute for Clinical Chemistry and Clinical Pharmacology, University of Bonn-Medical Center, 53127 Bonn, Germany;
| | - Laurien M. Buffart
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Arend Bökenkamp
- Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Pediatric Nephrology, 1081 HV Amsterdam, The Netherlands; (E.d.B.); (A.B.)
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22
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Bluhme E, Malenicka S, Fischler B, Nemeth A, Berg UB, Jorns C. Comparison of cystatin C, creatinine, and iohexol clearance in pediatric liver transplantation-a retrospective cohort study. Pediatr Transplant 2021; 25:e13993. [PMID: 34010490 DOI: 10.1111/petr.13993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 12/10/2020] [Accepted: 02/06/2021] [Indexed: 12/01/2022]
Abstract
Impaired renal function after pediatric (LT) is a recognized problem. Accurate monitoring of (GFR) is imperative to detect declining renal function. GFR can be estimated via s-creatinine and/or p-cystatin C or measured by inulin and or/iohexol clearances. We retrospectively compared eGFRcrea and eGFRcyst, to mGFRiohex after LT. Data from 91 children with 312 concomitant measurements of s-creatinine, p-cystatin C, and iohexol clearance, obtained between 2007 and 2015, were analyzed. eGFR was calculated by using the p-cystatin C-based CAPA and CKD-EPI formulas, and the s-creatinine-based Schwartz-LYON, FAS, revised Schwartz and MDRD formulas. Also, the arithmetic means of cystatin C-based and creatinine-based equations were used. Every calculated eGFR was compared to mGFRiohex in statistical correlation, accuracy, precision, bias, and misclassifications. Among the different equations, p-cystatin C-based formulas (CAPA and CKD-EPI) as well as the s-creatinine-based Schwartz-LYON formula showed the most correct estimates regarding accuracy (84-87.5%), bias (0.19-4.0 ml/min/1.73 m2 ), and misclassification rate (24.7-25%). In patients with renal function <75 ml/min/1.73 m2 , cystatin C-based formulas were significantly more accurate and less biased than creatinine-based formulas. In conclusion, S-creatinine could be used in a clinical setting on a regular basis in liver transplanted pediatric patients, with reliable results, if eGFR is calculated by the Schwartz-LYON formula. When suspected renal dysfunction, cystatin C-based eGFR should be calculated, since it gives more accurate and less biased estimates than creatinine-based eGFR, and should be confirmed by mGFR (iohexol).
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Affiliation(s)
- Emil Bluhme
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Silvia Malenicka
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital Huddinge, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Bjorn Fischler
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital Huddinge, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Antal Nemeth
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Hospital, Karolinska University Hospital Huddinge, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Ulla B Berg
- Department of Pediatric Nephrology, Astrid Lindgren Children's Hospital, Karolinska University Hospital Huddinge, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Carl Jorns
- Department of Transplantation Surgery, Karolinska University Hospital Huddinge, CLINTEC, Karolinska Institutet, Stockholm, Sweden
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23
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Hua Y, Chromek M, Frykman A, Jernberg C, Georgieva V, Hansson S, Zhang J, Marits AK, Wan C, Matussek A, Bai X. Whole-genome characterization of hemolytic uremic syndrome-causing Shiga toxin-producing Escherichia coli in Sweden. Virulence 2021; 12:1296-1305. [PMID: 33939581 PMCID: PMC8096335 DOI: 10.1080/21505594.2021.1922010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Shiga toxin-producing Escherichia coli, a foodborne bacterial pathogen, has been linked to a broad spectrum of clinical outcomes ranging from asymptomatic carriage to fatal hemolytic uremic syndrome (HUS). Here, we collected clinical data and STEC strains from HUS patients from 1994 through 2018, whole-genome sequencing was performed to molecularly characterize HUS-associated STEC strains, statistical analysis was conducted to identify bacterial genetic factors associated with severe outcomes in HUS patients. O157:H7 was the most predominant serotype (57%) among 54 HUS-associated STEC strains, followed by O121:H19 (19%) and O26:H11 (7%). Notably, some non-predominant serotypes such as O59:H17 (2%) and O109:H21 (2%) also caused HUS. All O157:H7 strains with one exception belonged to clade 8. During follow-up at a median of 4 years, 41% of the patients had renal sequelae. Fifty-nine virulence genes were found to be statistically associated with severe renal sequelae, these genes encoded type II and type III secretion system effectors, chaperones, and other factors. Notably, virulence genes associated with severe clinical outcomes were significantly more prevalent in O157:H7 strains. In contrast, genes related to mild symptoms were evenly distributed across all serotypes. The whole-genome phylogeny indicated high genomic diversity among HUS-STEC strains. No distinct cluster was found between HUS and non-HUS STEC strains. The current study showed that O157:H7 remains the main cause of STEC-associated HUS, despite the rising importance of other non-O157 serotypes. Besides, O157:H7 is associated with severe renal sequelae in the follow-up, which could be a risk factor for long-term prognosis in HUS patients.
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Affiliation(s)
- Ying Hua
- Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou, China.,Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Milan Chromek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Anne Frykman
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Valya Georgieva
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Sverker Hansson
- Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ji Zhang
- Molecular Epidemiology and Public Health Laboratory, School of Veterinary Sciences, Massey University, Palmerston North, New Zealand
| | - Ann Katrine Marits
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Chengsong Wan
- Department of Microbiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Andreas Matussek
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.,Laboratory Medicine, Jönköping Region County, Department of Clinical and Experimental Medicine, Linköping University, Jönköping, Sweden.,Oslo University Hospital, Oslo, Norway.,Division of Laboratory Medicine, Institute of Clinical Medicine, University of Oslo, Norway
| | - Xiangning Bai
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.,Division of Infectious Diseases, Department of Medicine Huddinge, Karolinska Institutet, Huddinge, Sweden.,State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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24
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Björk J, Nyman U, Larsson A, Delanaye P, Pottel H. Estimation of the glomerular filtration rate in children and young adults by means of the CKD-EPI equation with age-adjusted creatinine values. Kidney Int 2021; 99:940-947. [DOI: 10.1016/j.kint.2020.10.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/24/2020] [Accepted: 10/11/2020] [Indexed: 10/23/2022]
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25
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Lindberg M, Brokner M, Strand MF, Fredriksen PM. Distribution of creatinine and estimated glomerular filtration rate in healthy schoolchildren: The Health Oriented Pedagogical Project (HOPP). Scand J Clin Lab Invest 2021; 81:244-249. [PMID: 33779452 DOI: 10.1080/00365513.2021.1904281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Glomerular filtration rate (GFR) measured by urinary clearance of inulin is considered the gold standard for assessment of kidney function in both adults and children. Because the procedure is cumbersome, GFR is estimated (eGFR) using algorithms based on the observed relationship between measured GFR (mGFR) and more accessible biomarkers such as creatinine and cystatin C. In children, most of the data on this relationship is retrieved from patients with reduced kidney function. Nonetheless, eGFR equations are widely in use in healthy children to evaluate kidney status and diagnose kidney disease. The aim of the present study was to compare the distribution of eGFR using two established pediatric eGFR equations incorporating age, height and serum creatinine (Schwartz-Lyon and Full Age Spectrum-height) and two recently published equations restricted to age and serum creatinine (Lund-Malmö Revised 18 and European Kidney Function Consortium equation) in 1200 healthy schoolchildren age 6-12 years. In addition, we present 2.5th, median and 97.5th percentiles for serum creatinine stratified by age and gender. Depending on the equation used, mean eGFR ranged from 101.6 to 115.4 mL/min/1.73 m2. The lower 2.5th percentile ranged from 83.3 to 89.0 mL/min/1.73 m2 and the fraction of children with eGFR < 90 mL/min/1.73 m2 ranged from 2.9% to 9.8%. In conclusion, expected values of eGFR in healthy children are significantly dependent on the equation used. When decision limits for diagnosis or classification are applied to eGFR results, the related equation should be clearly stated.
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Affiliation(s)
- Morten Lindberg
- Department of Medical Biochemistry, Vestfold Hospital Trust, Tønsberg, Norway
| | - Mette Brokner
- Department of Medical Biochemistry, Vestfold Hospital Trust, Tønsberg, Norway
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26
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Leroux S, Biran V, van den Anker J, Gotta V, Zhao W, Zhang D, Jacqz-Aigrain E, Pfister M. Serum Creatinine and Serum Cystatin C are Both Relevant Renal Markers to Estimate Vancomycin Clearance in Critically Ill Neonates. Front Pharmacol 2021; 12:634686. [PMID: 33967770 PMCID: PMC8104087 DOI: 10.3389/fphar.2021.634686] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 02/12/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Serum creatinine (SCr) is used as a marker of kidney function to guide dosing of renally eliminated drugs. Serum Cystatin C (S-CysC) has been suggested as a more reliable kidney marker than SCr in adults and children. Purpose of this study was to investigate S-CysC as alternative renal marker to SCr for estimating vancomycin clearance in neonates undergoing intensive care. Methods: Vancomycin pharmacokinetics (PK), SCr and S-CysC data were collected in patients undergoing vancomycin treatment in the neonatal intensive care unit of Robert Debré Hospital - Paris. A population PK analysis was performed utilizing routine therapeutic drug monitoring samples. S-CysC and SCr were compared as covariates on vancomycin clearance using stepwise covariate modeling (forward inclusion [p < 0.05] and backward elimination [p < 0.01]). Model performance was evaluated by graphical and statistical criteria. Results: A total of 108 vancomycin concentrations from 66 patients (postmenstrual age [PMA] of 26–46 weeks) were modeled with an allometric one-compartment model. The median (range) values for SCr and S-CysC were 41 (12–153) µmol/l and 1.43 (0.95–2.83) mg/l, respectively. Following stepwise covariate model building, SCr was retained as single marker of kidney function (after accounting for weight and PMA) in the final model. Compared to the final model based on SCr, the alternative model based on S-CysC showed very similar performance (e.g. BIC of 578.3 vs. 576.4) but included one additional covariate: impact of mechanical ventilation on vancomycin clearance, in addition to the effects of size and maturation. Conclusion: ill neonates. However, if using S-CysC for this purpose mechanical ventilation needs to be taken into account.
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Affiliation(s)
- Stéphanie Leroux
- Department of Pediatrics/Neonatology, CIC 1414, CHU Rennes, Rennes, France.,Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel, University of Basel, Basel, Switzerland.,Department of Pediatric Pharmacology and Pharmacogenetics, Robert Debré Hospital, Paris, France
| | - Valérie Biran
- Neonatal Intensive Care Unit, Robert Debré Hospital, Paris, France
| | - John van den Anker
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel, University of Basel, Basel, Switzerland.,Division of Clinical Pharmacology, Children's National Hospital, Washington, D.C., WA, United States
| | - Verena Gotta
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Wei Zhao
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Shandong University, Jinan, China
| | - Daolun Zhang
- Department of Pediatric Pharmacology and Pharmacogenetics, Robert Debré Hospital, Paris, France
| | - Evelyne Jacqz-Aigrain
- Department of Pediatric Pharmacology and Pharmacogenetics, Robert Debré Hospital, Paris, France
| | - Marc Pfister
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel, University of Basel, Basel, Switzerland
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27
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Gaillard S, Roche L, Lemoine S, Deschênes G, Morin D, Vianey-Saban C, Acquaviva-Bourdain C, Ranchin B, Bacchetta J, Kassai B, Nony P, Bodénan E, Laudy V, Rouges C, Zarrabian S, Subtil F, Mercier C, Cochat P, Bertholet-Thomas A. Adherence to cysteamine in nephropathic cystinosis: A unique electronic monitoring experience for a better understanding. A prospective cohort study: CrYSTobs. Pediatr Nephrol 2021; 36:581-589. [PMID: 32901297 DOI: 10.1007/s00467-020-04722-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/22/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In nephropathic cystinosis (NC), adherence to cysteamine remains challenging; poor adherence is worsening the disease progression with a decline of kidney function and increase of extrarenal morbidities. Our objective was to describe adherence to cysteamine in NC patients, using electronic monitoring systems. METHODS Patients with confirmed NC, aged > 4 years and receiving oral cysteamine (short acting or delayed release formulation as standard of care) from 3 French reference centers, were included. Adherence to treatment was primarily assessed as the percentage of days with a good adherence score, adherence score rating from 0 (poor) to 2 (good). A descriptive analysis was performed after 1-year follow-up. RESULTS Seventeen patients (10 girls, median age: 13.9 (5.4-33.0) years) were included. Median age at diagnosis was 17.0 (3.0-76.9) months and age at start of cysteamine was 21.0 (15.5-116.3) months. Median daily dose of cysteamine was 1.05 (0.55-1.63) g/m2/day. Over the year, the median percentage of days with a good adherence score was 80 (1-99)% decreasing to 68 (1-99)% in patients > 11 years old. The median of average number of hours covered by treatment in a day was 22.5 (6.1-23.9) versus 14.9 (9.2-20.5) hours for delayed release versus short acting cysteamine. CONCLUSION Our data are the first describing a rather good adherence to cysteamine, decreasing in adolescents and adults. We described a potential interest of the delayed release formulation. Our data highlight the need for a multidisciplinary approach including therapeutic education and individualized approaches in NC patients transitioning to adulthood. Graphical abstract.
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Affiliation(s)
- Segolene Gaillard
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France. .,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.
| | - Laurent Roche
- Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Sandrine Lemoine
- Service de Néphrologie, Dialyse, Hypertension artérielle, Hôpital Edouard Herriot, Hospices Civils de Lyon, Université de Lyon, Lyon, France
| | - Georges Deschênes
- APHP, Hôpital Robert Debré, Service de néphrologie pédiatrique, Paris, France
| | - Denis Morin
- CHU Montpellier, Service de néphrologie et endocrinologie pédiatrique, Montpellier, France
| | - Christine Vianey-Saban
- Hospices Civils de Lyon, Service Biochimie et Biologie Moléculaire, UF Maladies Héréditaires du Métabolisme, F-69500, Bron, France
| | - Cécile Acquaviva-Bourdain
- Hospices Civils de Lyon, Service Biochimie et Biologie Moléculaire, UF Maladies Héréditaires du Métabolisme, F-69500, Bron, France
| | - Bruno Ranchin
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
| | - Justine Bacchetta
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
| | - Behrouz Kassai
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France.,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Patrice Nony
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France.,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Eurielle Bodénan
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France
| | - Valérie Laudy
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Department of Clinical Epidemiology, CHU-Lyon, F-69677, Bron, France.,Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Cécile Rouges
- CHU Montpellier, Centre d'Investigation Clinique, Inserm CIC 1411, F-69500, Bron, Montpellier, France
| | - Setareh Zarrabian
- Centre d'Investigation Clinique - CIC 1426 Hôpital Robert Debre - Assistance Publique - Hopitaux de Paris (AP-HP), Paris, France
| | - Fabien Subtil
- Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Catherine Mercier
- Université de Lyon, F-69000, Lyon, Université Lyon 1; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Pierre Cochat
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
| | - Aurélia Bertholet-Thomas
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales et phosphocalciques rares- Néphrogones- Filière ORKiD -69500, Bron, France
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28
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Pottel H, Björk J, Courbebaisse M, Couzi L, Ebert N, Eriksen BO, Dalton RN, Dubourg L, Gaillard F, Garrouste C, Grubb A, Jacquemont L, Hansson M, Kamar N, Lamb EJ, Legendre C, Littmann K, Mariat C, Melsom T, Rostaing L, Rule AD, Schaeffner E, Sundin PO, Turner S, Bökenkamp A, Berg U, Åsling-Monemi K, Selistre L, Åkesson A, Larsson A, Nyman U, Delanaye P. Development and Validation of a Modified Full Age Spectrum Creatinine-Based Equation to Estimate Glomerular Filtration Rate : A Cross-sectional Analysis of Pooled Data. Ann Intern Med 2021; 174:183-191. [PMID: 33166224 DOI: 10.7326/m20-4366] [Citation(s) in RCA: 160] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Chronic Kidney Disease in Children Study (CKiD) equation for children and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for adults are recommended serum creatinine (SCr)-based calculations for estimating glomerular filtration rate (GFR). However, these equations, as well as their combination, have limitations, notably the problem of implausible changes in GFR during the transition from adolescence to adulthood and overestimation of GFR in young adults. The full age spectrum (FAS) equation addresses these issues but overestimates GFR when SCr levels are low. OBJECTIVE To develop and validate a modified FAS SCr-based equation combining design features of the FAS and CKD-EPI equations. DESIGN Cross-sectional analysis with separate pooled data sets for development and validation. SETTING Research and clinical studies (n = 13) with measured GFR available. PATIENTS 11 251 participants in 7 studies (development and internal validation data sets) and 8378 participants in 6 studies (external validation data set). MEASUREMENTS Clearance of an exogenous marker (reference method), SCr level, age, sex, and height were used to develop a new equation to estimate GFR. RESULTS The new European Kidney Function Consortium (EKFC) equation is a FAS equation with low bias (-1.2 mL/min/1.73 m2 [95% CI, -2.7 to 0.0 mL/min/1.73 m2] in children and -0.9 mL/min/1.73 m2 [CI, -1.2 to -0.5 mL/min/1.73 m2] in adults) across the FAS (2 to 90 years) and SCr range (40 to 490 µmol/L [0.45 to 5.54 mg/dL]) and with fewer estimation errors exceeding 30% (6.5% [CI, 3.8% to 9.1%] in children and 3.1% [CI, 2.5% to 3.6%] in adults) compared with the CKiD and CKD-EPI equations. LIMITATION No Black patients were included. CONCLUSION The new EKFC equation shows improved accuracy and precision compared with commonly used equations for estimating GFR from SCr levels. PRIMARY FUNDING SOURCE Swedish Research Council (Vetenskapsrådet).
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Affiliation(s)
- Hans Pottel
- KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (H.P.)
| | - Jonas Björk
- Lund University and Skåne University Hospital, Lund, Sweden (J.B., A.Å.)
| | - Marie Courbebaisse
- Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Paris Descartes University, INSERM U1151-CNRS UMR8253, Paris, France (M.C.)
| | - Lionel Couzi
- CHU de Bordeaux, Université de Bordeaux, CNRS-UMR 5164 Immuno ConcEpT, Bordeaux, France (L.C.)
| | - Natalie Ebert
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.)
| | - Björn O Eriksen
- UiT The Arctic University of Norway, Tromsö, Norway (B.O.E., T.M.)
| | - R Neil Dalton
- Evelina London Children's Hospital, London, United Kingdom (R.N.D.)
| | - Laurence Dubourg
- Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France (L.D.)
| | | | - Cyril Garrouste
- Clermont-Ferrand University Hospital, Clermont-Ferrand, France (C.G.)
| | - Anders Grubb
- Skåne University Hospital and Lund University, Lund, Sweden (A.G.)
| | | | - Magnus Hansson
- Karolinska University Hospital Huddinge and Karolinska Institute, Stockholm, Sweden (M.H.)
| | - Nassim Kamar
- CHU Rangueil, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France (N.K.)
| | - Edmund J Lamb
- East Kent Hospitals University NHS Foundation Trust, Canterbury, United Kingdom (E.J.L.)
| | - Christophe Legendre
- Hôpital Necker, Assistance Publique Hôpitaux de Paris (AP-HP)and Université Paris Descartes, Paris, France (C.L.)
| | | | | | - Toralf Melsom
- UiT The Arctic University of Norway, Tromsö, Norway (B.O.E., T.M.)
| | - Lionel Rostaing
- Hôpital Michallon, CHU Grenoble-Alpes, La Tronche, France (L.R.)
| | | | - Elke Schaeffner
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany (N.E., E.S.)
| | | | | | - Arend Bökenkamp
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands (A.B.)
| | - Ulla Berg
- Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden (U.B., K.Å.)
| | - Kajsa Åsling-Monemi
- Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden (U.B., K.Å.)
| | - Luciano Selistre
- Mestrado em Ciências da Saúde-Universidade Caxias do Sul Foundation CAPES, Caxias do Sul, Brazil (L.S.)
| | - Anna Åkesson
- Lund University and Skåne University Hospital, Lund, Sweden (J.B., A.Å.)
| | - Anders Larsson
- Skåne University Hospital, Lund, Sweden; Uppsala University, Uppsala, Sweden (A.L.)
| | - Ulf Nyman
- Lund University, Malmö, Sweden (U.N.)
| | - Pierre Delanaye
- University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium, and Hôpital Universitaire Carémeau, Nîmes, France (P.D.)
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Matsuoka D, Hirabayashi K, Murase T, Saito S, Hidaka Y, Nakazawa Y. Assessment of kidney function using inulin-based and estimated glomerular filtration rates before and after allogeneic hematopoietic stem cell transplantation in pediatric patients. Pediatr Blood Cancer 2020; 67:e28733. [PMID: 33001557 DOI: 10.1002/pbc.28733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Accurate evaluation of kidney function before and after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is important for both informed decision making and detection of chronic kidney disease. However, to the best of our knowledge, no report has evaluated the glomerular filtration rate (GFR) in pediatric patients who underwent HSCT using the gold standard GFR measurement, as well as inulin-based GFR (iGFR). METHODS We assessed iGFR before and after allo-HSCT to evaluate the impact of allo-HSCT on GFR in a prospective cohort study of 17 pediatric patients. We also assessed the accuracy and bias of the values of estimated GFR (eGFR) calculated using serum creatinine (Cr), cystatin C (CysC), beta-2 microglobulin (β2 MG), 24-h creatinine clearance (24hCcr), and the full chronic kidney disease in children (CKiD) index that combines Cr, CysC, and blood urea nitrogen-based equations with iGFR as a reference to identify the most reliable equation for GFR. RESULTS There was no significant difference between the values before and after allo-HSCT. CKiD CysC-, 24hCcr-, and full CKiD-based values showed good within 30% (P30) accuracy (80.6%, 79.3%, and 80.6%, respectively), but only 24hCcr and full CKiD had good mean bias (8.5% and 8.9%, respectively) and narrow 95% limits of agreement (-32.2 to 52.7 mL/min/1.73 m2 and -29.3 to 47.4 mL/min/1.73 m2 , respectively) compared with the corresponding iGFR. CONCLUSION There was no significant impact of allo-HSCT on GFR in our cohort. The most reliable equations for pediatric patients with allo-HSCT were eGFR-24hCcr and eGFR-full CKiD.
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Affiliation(s)
- Daisuke Matsuoka
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Koichi Hirabayashi
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tsubasa Murase
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shoji Saito
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshihiko Hidaka
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan
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Should we abandon GFR in the decision to initiate chronic dialysis? Pediatr Nephrol 2020; 35:1593-1600. [PMID: 31418062 DOI: 10.1007/s00467-019-04333-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 12/20/2022]
Abstract
The best time to start chronic dialysis during the course of CKD stage 5 is controversial. The first randomised control trial of dialysis initiation either in early or late CKD stage 5 in adults (IDEAL study), and 3 studies from the two largest paediatric registries, the U.S. Renal Data System (USRDS) and the European Society of Paediatric Nephrology (ESPN) Registry, have now provided us with evidence to guide us in this important decision-making process. The message 'no benefit from early start of dialysis' is the conclusion from all four studies. However, what are the limitations of these studies? Can GFR be assessed at CKD stages 4 and 5? What are the factors used to assess the benefit of early or late start? These issues are discussed in this review.
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Lopez-Ruiz A, Kashani K. Assessment of muscle mass in critically ill patients: role of the sarcopenia index and images studies. Curr Opin Clin Nutr Metab Care 2020; 23:302-311. [PMID: 32657790 DOI: 10.1097/mco.0000000000000673] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Sarcopenia is a progressive generalized decline in skeletal muscle mass, strength, and function. This condition is highly prevalent in critically ill patients and is associated with poor outcomes in the ICU. In this review, we describe the use, evidence, and limitations of the most common validated imaging studies used to assess muscle mass in ICU, and we provide an overview of the benefits of using the sarcopenia index [(serum creatinine/serum cystatin C) × 100]) in the ICU. RECENT FINDINGS Currently, the determination of muscle mass using anthropometric measurements and serum biomarkers is unreliable. Several new techniques, including a dual-energy X-ray absorptiometry, computed tomography scan, ultrasonography, and bioimpedance analysis, have been studied and validated for the diagnosis and prognosis of sarcopenia in the ICU. However, these techniques are often not accessible for the majority of critically ill patients. The sarcopenia index constitutes an accurate method to diagnose sarcopenia, predict ICU outcomes, and nutritional status in critically ill patients. SUMMARY Diagnosis of sarcopenia has substantial implications in ICU patients. Choosing the correct test to identify patients who may need preventive or therapeutic support for this condition will favorably impact ICU outcomes.
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Affiliation(s)
- Arnaldo Lopez-Ruiz
- Division of Critical Care, AdventHealth Medical Group, AdventHealth Orlando, Florida
| | - Kianoush Kashani
- Division of Nephrology and Hypertension
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Björk J, Nyman U, Courbebaisse M, Couzi L, Dalton RN, Dubourg L, Ebert N, Eriksen BO, Gaillard F, Garrouste C, Grubb A, Hansson M, Jacquemont L, Jones I, Kamar N, Lamb EJ, Legendre C, Littmann K, Mariat C, Melsom T, Rostaing L, Rule AD, Schaeffner E, Sundin PO, Turner S, Åkesson A, Delanaye P, Pottel H. Prospects for improved glomerular filtration rate estimation based on creatinine-results from a transnational multicentre study. Clin Kidney J 2020; 13:674-683. [PMID: 32905314 PMCID: PMC7467594 DOI: 10.1093/ckj/sfaa039] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 03/04/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved. METHODS In a cross-sectional analysis covering the years 2003-17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund-Malmö revised equation (LMR) and the Full Age Spectrum equation. RESULTS 7In patients aged 18-39 years old, CKD-EPI overestimated GFR with 5.0-16 mL/min/1.73 m2 in median in both cohort types at mGFR levels <120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%. CONCLUSIONS None of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.
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Affiliation(s)
- Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Marie Courbebaisse
- Physiology Department, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, INSERM U1151-CNRS UMR8253, Paris, France
| | - Lionel Couzi
- CHU de Bordeaux, Nephrologie–Transplantation–Dialyse, Université de Bordeaux, CNRS-UMR 5164 Immuno ConcEpT, Bordeaux, France
| | - R Neil Dalton
- The Wellchild Laboratory, Evelina London Children’s Hospital, London, UK
| | - Laurence Dubourg
- Néphrologie, Dialyse, Hypertension et Exploration Fonctionnelle Rénale, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Natalie Ebert
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Björn O Eriksen
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Francois Gaillard
- Renal Transplantation Department, Necker Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France
| | - Cyril Garrouste
- Department of Nephrology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital Lund, Lund University, Lund, Sweden
| | - Magnus Hansson
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Lola Jacquemont
- Renal Transplantation Department, CHU Nantes, Nantes University, Nantes, France
| | - Ian Jones
- Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, CHU Rangueil, INSERM U1043, IFR–BMT, University Paul Sabatier, Toulouse, France
| | - Edmund J Lamb
- Clinical Biochemistry, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | | | - Karin Littmann
- Function area Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Christophe Mariat
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital Nord, CHU de Saint-Etienne, France
| | - Toralf Melsom
- Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsö, Norway
| | - Lionel Rostaing
- Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, Hôpital Michallon, CHU Grenoble-Alpes, La Tronche, France
| | - Andrew D Rule
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Elke Schaeffner
- Charité Universitätsmedizin Berlin, Institute of Public Health, Berlin, Germany
| | - Per-Ola Sundin
- Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Stephen Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Anna Åkesson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Forum South, Skåne University Hospital, Lund, Sweden
| | - Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
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Trautmann A, Vivarelli M, Samuel S, Gipson D, Sinha A, Schaefer F, Hui NK, Boyer O, Saleem MA, Feltran L, Müller-Deile J, Becker JU, Cano F, Xu H, Lim YN, Smoyer W, Anochie I, Nakanishi K, Hodson E, Haffner D. IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome. Pediatr Nephrol 2020; 35:1529-1561. [PMID: 32382828 PMCID: PMC7316686 DOI: 10.1007/s00467-020-04519-1] [Citation(s) in RCA: 156] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/07/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023]
Abstract
Idiopathic nephrotic syndrome newly affects 1-3 per 100,000 children per year. Approximately 85% of cases show complete remission of proteinuria following glucocorticoid treatment. Patients who do not achieve complete remission within 4-6 weeks of glucocorticoid treatment have steroid-resistant nephrotic syndrome (SRNS). In 10-30% of steroid-resistant patients, mutations in podocyte-associated genes can be detected, whereas an undefined circulating factor of immune origin is assumed in the remaining ones. Diagnosis and management of SRNS is a great challenge due to its heterogeneous etiology, frequent lack of remission by further immunosuppressive treatment, and severe complications including the development of end-stage kidney disease and recurrence after renal transplantation. A team of experts including pediatric nephrologists and renal geneticists from the International Pediatric Nephrology Association (IPNA), a renal pathologist, and an adult nephrologist have now developed comprehensive clinical practice recommendations on the diagnosis and management of SRNS in children. The team performed a systematic literature review on 9 clinically relevant PICO (Patient or Population covered, Intervention, Comparator, Outcome) questions, formulated recommendations and formally graded them at a consensus meeting, with input from patient representatives and a dietician acting as external advisors and a voting panel of pediatric nephrologists. Research recommendations are also given.
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Affiliation(s)
- Agnes Trautmann
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany
| | - Marina Vivarelli
- Department of Pediatric Subspecialties, Division of Nephrology and Dialysis, Bambino Gesù Pediatric Hospital and Research Center, Rome, Italy
| | - Susan Samuel
- Department of Pediatrics, Section of Pediatric Nephrology, Alberta Children's Hospital, University of Calgary, Calgary, Canada
| | - Debbie Gipson
- Division of Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Aditi Sinha
- Department of Pediatrics, Division of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany
| | - Ng Kar Hui
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Olivia Boyer
- Laboratory of Hereditary Kidney Diseases, Imagine Institute, INSERM U1163, Paris Descartes University, Paris, France
- Department of Pediatric Nephrology, Reference Center for Idiopathic Nephrotic Syndrome in Children and Adults, Necker Hospital, APHP, 75015, Paris, France
| | - Moin A Saleem
- Department of Pediatric Nephrology, Bristol Royal Hospital for Children, University of Bristol, Bristol, UK
| | - Luciana Feltran
- Hospital Samaritano and HRim/UNIFESP, Federal University of São Paulo, São Paulo, Brazil
| | | | - Jan Ulrich Becker
- Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - Francisco Cano
- Department of Nephrology, Luis Calvo Mackenna Children's Hospital, University of Chile, Santiago, Chile
| | - Hong Xu
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Yam Ngo Lim
- Department of Pediatrics, Prince Court Medical Centre, Kuala Lumpur, Malaysia
| | - William Smoyer
- The Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - Ifeoma Anochie
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Koichi Nakanishi
- Department of Child Health and Welfare (Pediatrics), Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Elisabeth Hodson
- Cochrane Kidney and Transplant, Centre for Kidney Research, The Children's Hospital at Westmead and the Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Dieter Haffner
- Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School Children's Hospital, Hannover, Germany.
- Department of Paediatric Kidney, Liver and Metabolic Diseases, Paediatric Research Center, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
- Center for Rare Diseases, Hannover Medical School Children's Hospital, Hannover, Germany.
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Björk J, Nyman U, Delanaye P, Grubb A, Larsson A, Vranken L, Åkesson A, Pottel H. A novel method for creatinine adjustment makes the revised Lund–Malmö GFR estimating equation applicable in children. Scand J Clin Lab Invest 2020; 80:456-463. [DOI: 10.1080/00365513.2020.1774641] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Clinical Studies Sweden, Skåne University Hospital, Lund, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium
- Department of Nephrology-Dialysis-Apheresis, Hopital Universitaire Caremeau, Nimes, France
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund, Lund University, Lund, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Laura Vranken
- Department of Clinical Chemistry, University of Liège (ULg CHU), CHU Sart Tilman, Liège, Belgium
| | - Anna Åkesson
- Clinical Studies Sweden, Skåne University Hospital, Lund, Sweden
| | - Hans Pottel
- Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
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Yodoshi T, Arce-Clachar AC, Sun Q, Fei L, Bramlage K, Xanthakos SA, Flores F, Mouzaki M. Glomerular Hyperfiltration Is Associated with Liver Disease Severity in Children with Nonalcoholic Fatty Liver Disease. J Pediatr 2020; 222:127-133. [PMID: 32381466 PMCID: PMC8218655 DOI: 10.1016/j.jpeds.2020.03.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/20/2020] [Accepted: 03/17/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To determine the prevalence of renal impairment in a large cohort of youths with histologically confirmed nonalcoholic fatty liver disease (NAFLD), and to determine its association with liver disease severity. STUDY DESIGN Clinical, laboratory, and histology data were collected retrospectively in a pediatric cohort with biopsy-confirmed NAFLD at a tertiary care center between 2010 and 2017. Histological NAFLD severity was scored using validated criteria. Glomerular filtration rate (GFR) was calculated and categorized as low (<90 mL/min/1.73 m2), normal (90-136 mL/min/1.73 m2), or high (>136 mL/min/1.73 m2). Univariate and multivariate modeling were used to determine differences between the GFR groups and to control for confounders. RESULTS The cohort comprised 179 patients (82% non-Hispanic; median age; 14 years; IQR, 12-16 years). One-third of the patients had abnormal renal function, including 36 (20%) with glomerular hyperfiltration and 26 (15%) with low GFR. In multivariable logistic regression, compared with normal GFR, hyperfiltration was independently associated with higher NAFLD activity score (aOR, 2.96; 95% CI, 1.49-5.87; P = .002), after adjusting for age, sex, ethnicity, obesity severity, presence of type 2 diabetes mellitus, and medications. CONCLUSIONS In this large cohort with histologically confirmed NAFLD, renal impairment was highly prevalent and associated with liver disease severity, independent of obesity severity. Screening patients with confirmed NAFLD for renal complication is recommended.
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Affiliation(s)
- Toshifumi Yodoshi
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Ana Catalina Arce-Clachar
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH
| | - Qin Sun
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Lin Fei
- Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH,Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Kristin Bramlage
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Stavra A. Xanthakos
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH,Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH
| | - Francisco Flores
- Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH,Division of Nephrology and Hypertension, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Marialena Mouzaki
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH.
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Chai L, Feng W, Zhai C, Shi W, Wang J, Yan X, Wang Q, Zhang Q, Li M. The association between cystatin C and COPD: a meta-analysis and systematic review. BMC Pulm Med 2020; 20:182. [PMID: 32586317 PMCID: PMC7318461 DOI: 10.1186/s12890-020-01208-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 06/03/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In recent years, many studies have discovered that cystatin C (Cys C) may play an important role in respiratory diseases, especially in chronic obstructive pulmonary disease (COPD). However, the findings of these studies were inconsistent. This systematic review and meta-analysis aimed to assess the relationship between serum Cys C and COPD. METHODS We conducted a systematic literature search in PubMed, Embase, Web of Science, Wanfang databases, and the China National Knowledge Infrastructure. The standardized mean difference (SMD), Fisher's Z-value and 95% confidence interval (CI) were calculated to investigate the effect sizes. Subgroup analyses were performed on disease status, ethnicity, assay method, and study design. Sensitivity was performed, and publication bias was assessed. RESULTS A total of 15 studies, including 4079 COPD patients and 5949 controls, were included in this meta-analysis. The results showed that serum Cys C levels in patients with COPD were significantly higher than those in controls (SMD = 0.99, 95% CI =0.62-1.37, P < 0.001), especially in AECOPD (SMD = 1.59, 95% CI =1.05-2.13, P < 0.001), and there were statistically different among AECOPD and SCOPD (SMD = 0.35, 95% CI =0.10-0.59, P = 0.005). The serum Cys C levels were negatively correlated with FEV1%pre (Z = - 0.45, 95%CI = -0.58--0.32, P = 0.011) and FEV1/FVC (Z = - 0.32, 95%CI = -0.50--0.14, P = 0.006). The serum Cys C levels were independent of ethnicity, assay method, and study design. CONCLUSION Serum Cys C levels were associated with COPD and COPD exacerbation, and they were inversely correlated with FEV1%pre and FEV1/FVC.
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Affiliation(s)
- Limin Chai
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Wei Feng
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Cui Zhai
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Wenhua Shi
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Jian Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Xin Yan
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Qingting Wang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Qianqian Zhang
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Manxiang Li
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an, 710061 Shaanxi People’s Republic of China
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Åkesson A, Lindström V, Nyman U, Jonsson M, Abrahamson M, Christensson A, Björk J, Grubb A. Shrunken pore syndrome and mortality: a cohort study of patients with measured GFR and known comorbidities. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:412-422. [DOI: 10.1080/00365513.2020.1759139] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Anna Åkesson
- Clinical Studies Sweden – Forum South, Skåne University Hospital, Lund, Sweden
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Veronica Lindström
- Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
| | - Ulf Nyman
- Department of Translational Medicine, Division of Medical Radiology, Lund University, Malmö, Sweden
| | - Magnus Jonsson
- Department of Clinical Chemistry, Skåne University Hospital, Malmö, Sweden
| | | | - Anders Christensson
- Department of Nephrology, Skåne University Hospital, Malmö, Lund University, Sweden
| | - Jonas Björk
- Clinical Studies Sweden – Forum South, Skåne University Hospital, Lund, Sweden
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Anders Grubb
- Department of Clinical Chemistry, Skåne University Hospital, Lund University, Lund, Sweden
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Goetschalckx E, Mekahli D, Levtchenko E, Allegaert K. Glomerular Filtration Rate in Former Extreme Low Birth Weight Infants over the Full Pediatric Age Range: A Pooled Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062144. [PMID: 32213814 PMCID: PMC7142917 DOI: 10.3390/ijerph17062144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 03/20/2020] [Indexed: 12/21/2022]
Abstract
Various cohort studies document a lower glomerular filtration rate (GFR) in former extremely low birth weight (ELBW, <1000 g) neonates throughout childhood when compared to term controls. The current aim is to pool these studies to describe the GFR pattern over the pediatric age range. To do so, we conducted a systematic review on studies reporting on GFR measurements in former ELBW cases while GFR data of healthy age-matched controls included in these studies were co-collected. Based on 248 hits, 6 case-control and 3 cohort studies were identified, with 444 GFR measurements in 380 former ELBW cases (median age 5.3–20.7 years). The majority were small (17–78 cases) single center studies, with heterogeneity in GFR measurement (inulin, cystatin C or creatinine estimated GFR formulae) tools. Despite this, the median GFR (mL/min/1.73 m2) within case-control studies was consistently lower (−13%, range −8% to −25%) in cases, so that a relevant minority (15–30%) has a eGFR<90 mL/min/1.73 m2). Consequently, this pooled analysis describes a consistent pattern of reduced eGFR in former ELBW cases throughout childhood. Research should focus on perinatal risk factors for impaired GFR and long-term outcome, but is hampered by single center cohorts, study size and heterogeneity of GFR assessment tools.
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Affiliation(s)
- Elise Goetschalckx
- Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (E.G.); (D.M.); (E.L.)
| | - Djalila Mekahli
- Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (E.G.); (D.M.); (E.L.)
- Department of Pediatric Nephrology and Organ Transplantation, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Elena Levtchenko
- Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (E.G.); (D.M.); (E.L.)
- Department of Pediatric Nephrology and Organ Transplantation, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; (E.G.); (D.M.); (E.L.)
- Department of Pharmacy and Pharmaceutical Sciences, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
- Department of Clinical Pharmacy, Wytemaweg Hospital Pharmacy Postbus 2040, Erasmus MC, Rotterdam, The Netherlands
- Correspondence:
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Kalyesubula R, Fabian J, Nakanga W, Newton R, Ssebunnya B, Prynn J, George J, Wade AN, Seeley J, Nitsch D, Hansen C, Nyirenda M, Smeeth L, Naicker S, Crampin AC, Tomlinson LA. How to estimate glomerular filtration rate in sub-Saharan Africa: design and methods of the African Research into Kidney Diseases (ARK) study. BMC Nephrol 2020; 21:20. [PMID: 31941441 PMCID: PMC6964098 DOI: 10.1186/s12882-020-1688-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 01/08/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a substantial cause of morbidity and mortality worldwide with disproportionate effects in sub-Saharan Africa (SSA). The optimal methods to estimate glomerular filtration rate (GFR) and therefore to determine the presence of CKD in SSA are uncertain. We plan to measure iohexol excretion to accurately determine GFR in Malawi, South Africa and Uganda. We will then assess the performance of existing equations to estimate GFR and determine whether a modified equation can better improve estimation of GFR in sub-Saharan Africa. METHODS The African Research on Kidney Disease (ARK) study is a three-country study embedded within existing cohorts. We seek to enrol 3000 adults > 18 years based on baseline serum creatinine. Study procedures include questionnaires on socio-demographics and established risk factors for kidney disease along with anthropometry, body composition, blood pressure, blood chemistry and urine microscopy and albuminuria. We will measure GFR (mGFR) by plasma clearance of iohexol at 120, 180 and 240 min. We will compare eGFR determined by established equations with mGFR using Bland-Altman plots. We will use regression methods to estimate GFR and compare the newly derived model with existing equations. DISCUSSION Through the ARK study, we aim to establish the optimal approach to estimate GFR in SSA. The study has the advantage of drawing participants from three countries, which will increase the applicability of the findings across the region. It is also embedded within established cohorts that have longitudinal information and serial measures that can be used to characterize kidney disease over a period of time. This will help to overcome the limitations of previous research, including small numbers, selected population sub-groups, and lack of data on proteinuria. The ARK collaboration provides an opportunity for close working partnerships across different centres, using standardized protocols and measurements, and shared bio-repositories. We plan to build on the collaboration for this study for future work on kidney disease in sub-Saharan Africa, and welcome additional partners from across the continent.
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Affiliation(s)
- Robert Kalyesubula
- Medical Research Council/ UVRI & London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda. .,Makerere University College of Health Sciences, Kampala, Uganda. .,London School of Hygiene & Tropical Medicine, London, UK.
| | - June Fabian
- Wits Donald Gordon Medical Centre, Parktown, Johannesburg, South Africa.,Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wisdom Nakanga
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Robert Newton
- Medical Research Council/ UVRI & London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda
| | - Billy Ssebunnya
- Medical Research Council/ UVRI & London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda
| | - Josephine Prynn
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Jaya George
- Department of Chemical Pathology, National Health Laboratory Services, University of Witwatersrand, Johannesburg, South Africa
| | - Alisha N Wade
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Janet Seeley
- Medical Research Council/ UVRI & London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda.,London School of Hygiene & Tropical Medicine, London, UK
| | | | - Christian Hansen
- Medical Research Council/ UVRI & London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda.,London School of Hygiene & Tropical Medicine, London, UK
| | - Moffat Nyirenda
- Medical Research Council/ UVRI & London School of Hygiene and Tropical Medicine Research Unit, Entebbe, Uganda.,London School of Hygiene & Tropical Medicine, London, UK.,Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Liam Smeeth
- London School of Hygiene & Tropical Medicine, London, UK
| | - Saraladevi Naicker
- Department of Internal Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Amelia C Crampin
- London School of Hygiene & Tropical Medicine, London, UK.,Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
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