Automated estimated GFR reporting in children using a height independent formula - 08/12/17
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Résumé |
Background and aims |
Reporting estimated glomerular filtration rate (eGFR) is established adult practice. The eGFR formula in children commonly require height which is not routinely available. We report optimisation and validation of a height-independent eGFR formula, biochemistry reporting of this formula and the impact of reporting eGFR on nephrology referrals.
Methods |
A total of 117 paediatric patients (60 male, mean age 10.5 years) who underwent a nuclear medicine GFR (mGFR) from April 2013 until October 2014 in Nottingham Children's Hospital (NCH) were identified. The eGFR was calculated using published formula. The Solver function of Excel to minimise the sum of the squares of the differences between the eGFR and mGFR was used to locally optimise the formula (Table 1). Validation consisted of 90 paediatric patients (55 male, mean age 7.7 years) who underwent a mGFR in Sheffield Children's Hospital (SCH) between January 2012 and September 2015. The NCH biochemistry reporting system was programmed to report eGFR. Manually calculated eGFR in 20 patients (13 male, median age 9.6 years) were compared to the reported eGFR. We collected data on referrals before and after the introduction of eGFR reporting on 10th March 2016.
Results |
The accuracy of each formula was assessed and compared to two commonly used adult formula (Table 2). The biochemistry reporting system was accurate (Fig. 1). Following introduction of the automated report, there was an increase in telephone referrals and requests for renal ultrasound. One patient was identified with renal scarring.
Conclusions |
Automated reporting of eGFR is feasible in children. We are reporting eGFR in all hospitalised children age 2 to 16 years of age whenever a serum creatinine is checked. This has not previously been described in paediatrics. This has been shown to lead to earlier identification of patients with CKD in adult services and should now become a standard of care in paediatric services.
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Vol 24 - N° 12
P. 1334-1335 - décembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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