Height-independent estimation of glomerular filtration rate in children: an alternative to the Schwartz equation

J Pediatr. 2013 Dec;163(6):1722-7. doi: 10.1016/j.jpeds.2013.08.031. Epub 2013 Oct 2.


Objective: To compare the diagnostic performance of 2 height-independent equations used to calculate estimated glomerular filtration rate (eGFR), those of Pottel (eGFR-Pottel) and the British Columbia Children's Hospital (BCCH) (eGFR-BCCH), with the commonly used Schwartz equation (eGFR-Schwartz).

Study design: We externally validated eGFR-Pottel and eGFR-BCCH in a well-characterized pediatric patient population (n = 152) and compared their diagnostic performance with that of eGFR-Schwartz using Bland-Altman analysis. All patients underwent glomerular filtration rate measurement using the gold standard single-injection inulin clearance method (GFR-inulin).

Results: Median GFR-inulin was 92.0 mL/min/1.73 m² (IQR, 76.1-107.4 mL/min/1.73 m²). Compared with GFR-inulin, the mean bias for eGFR-Schwartz was -10.1 mL/min/1.73 m(2) (95% limits of agreement [LOA], -77.5 to 57.2 mL/min/1.73 m(2)), compared with -12.3 mL/min/1.73 m² (95% LOA, -72.6 to 47.9 mL/min/1.73 m(2)) for eGFR-Pottel and -22.1 mL/min/1.73 m² (95% LOA, -105.0 to 60.8 mL/min/1.73 m(2)) for eGFR-BCCH. eGFR-Pottel showed comparable accuracy to eGFR-Schwartz, with 77% and 76% of estimates within 30% of GFR-inulin, respectively. eGFR-BCCH was less accurate than eGFR-Schwartz (66% of estimates within 30% of GFR-inulin; P < .01).

Conclusion: The performance of eGFR-Pottel is superior to that of eGFR-BCCH and comparable with that of eGFR-Schwartz. eGFR-Pottel is a valid alternative to eGFR-Schwartz in children and could be reported by the laboratory if height data are not available.

Keywords: BCCH; British Columbia Children's Hospital; CKD; Chronic kidney disease; Estimated glomerular filtration rate; Estimated glomerular filtration rate according to the British Columbia Children's Hospital equation; Estimated glomerular filtration rate according to the Pottel equation; Estimated glomerular filtration rate according to the Schwartz equation; GFR; GFR-inulin; Glomerular filtration rate; Glomerular filtration rate measured by the single-injection inulin clearance method; IDMS; Isotope dilution mass spectrometry; LOA; Limits of agreement; eGFR; eGFR-BCCH; eGFR-Pottel; eGFR-Schwartz.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Body Height*
  • Child
  • Child, Preschool
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Infant
  • Male
  • Mathematics
  • Retrospective Studies
  • Young Adult