Kidney function reference values in US adolescents: National Health And Nutrition Examination Survey 1999-2008

Clin J Am Soc Nephrol. 2011 Aug;6(8):1956-62. doi: 10.2215/CJN.10311110. Epub 2011 Jul 22.


Background and objectives: Few data are available on kidney function in normal US adolescents. This study characterizes the distribution of kidney function measures and associated factors.

Design, setting, participants, & measurements: Serum creatinine, cystatin C, and urinary albumin-to-creatinine ratios were measured in US adolescents (aged 12 to 17 years; n = 5575) in the cross-sectional National Health and Nutrition Examination Survey 1999-2008. The reference population was defined as healthy adolescents with BP <120/80 mmHg and a Z-score for weight-to-height ≤1.645, without self-reported diabetes or hypertension, not using prescription medications in the preceding 30 days, not pregnant or currently menstruating.

Results: were analyzed by age, gender, race, ethnicity, body mass index, and BP; estimated GFR (eGFR) was calculated using the original and revised Schwartz formulas. Results Mean values for eGFR(Schwartz original formula), serum creatinine, and serum cystatin C were 147 ml/min/1.73 m(2), 0.71 mg/dl, 0.82 mg/L, respectively. The median urinary albumin-to-creatinine ratio was 6.8 mg/g creatinine. In the reference population (n = 2881), eGFR differed significantly using the two Schwartz formulas; values were higher using the original formula (median values 143 versus 96 ml/min/1.73 m(2)). Serum creatinine level (0.7 versus 0.72 mg/dl), but not cystatin C level (0.82 versus 0.82 mg/L), was lower in the reference population than in a nonreference population of adolescents.

Conclusions: These findings provide important demographic information and highlight the need for confirmatory testing of the revised Schwartz formula by comparison to measured GFR in healthy US adolescents.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Age Factors
  • Albumins / analysis
  • Biomarkers / blood
  • Biomarkers / urine
  • Blood Pressure
  • Body Height
  • Body Weight
  • Child
  • Creatinine / blood
  • Creatinine / urine
  • Cross-Sectional Studies
  • Cystatin C / blood
  • Female
  • Glomerular Filtration Rate
  • Health Surveys
  • Humans
  • Kidney / physiology*
  • Kidney Function Tests / standards*
  • Linear Models
  • Male
  • Models, Biological
  • Predictive Value of Tests
  • Reference Values
  • United States


  • Albumins
  • Biomarkers
  • CST3 protein, human
  • Cystatin C
  • Creatinine