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Normalization of glomerular filtration rate in obese children

Title
Normalization of glomerular filtration rate in obese children
Type
Article in International Scientific Journal
Year
2016
Authors
Correia Costa, L
(Author)
Other
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Schaefer, F
(Author)
Other
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Alberto Caldas Afonso
(Author)
FMUP
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Bustorff, M
(Author)
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guimaraes, jt
(Author)
FMUP
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Antonio Guerra
(Author)
FMUP
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Barros H
(Author)
FMUP
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Azevedo A
(Author)
FMUP
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Journal
Title: Pediatric NephrologyImported from Authenticus Search for Journal Publications
Vol. 31
Pages: 1321-1328
ISSN: 0931-041X
Publisher: Springer Nature
Other information
Authenticus ID: P-00K-B88
Abstract (EN): Background Glomerular filtration rate (GFR) is conventionally indexed to body surface area (BSA), but this may lead to biased results when applied to subjects of abnormal body size. The aim of our study was to examine the impact of normalization to the BSA and alternative body size descriptors on measured and estimated GFR in overweight and obese children. This was a cross-sectional study of 313 children aged 8-9 years old. GFR was measured by 24-h creatinine clearance (CrCl) and additionally estimated from serum creatinine and cystatin C (CysC) using the combined Zappitelli formula, both as absolute values and adjusted to various body size descriptors. The results were compared between 163 normal-weight, 89 overweight and 61 obese children. Compared to the normal-weight children, mean absolute GFR (both measured and estimated) was higher in the overweight and obese children, whereas BSA-adjusted GFR was lower. Linear regression models fitted in normal-weight children revealed equally close associations between absolute GFR and squared height, ideal body weight (IBW) and BSA derived from IBW. Normalization of GFR to the IBW-derived BSA completely eliminated the discrepancy between absolute and BSA-indexed GFR in overweight and obese children. Indexing of GFR to BSA calculated from the ideal-rather than actual-body weight is a promising approach to avoid overcorrection when studying obese children. Further studies should assess the accuracy of this approach across the full range of age and BMI distribution.
Language: English
Type (Professor's evaluation): Scientific
No. of pages: 8
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