{"title":"Measuring and estimating the GFR in children: state of the art in 2025.","authors":"Hans Pottel, George J Schwartz","doi":"10.1007/s00467-025-06724-2","DOIUrl":null,"url":null,"abstract":"<p><p>Glomerular filtration rate (GFR) can be measured directly, or estimated from biomarkers like serum creatinine and cystatin C, or both. Measuring GFR in children is cumbersome, as it requires the intravenous injection of an exogenous filtration marker like iohexol, and several blood samples to determine the concentration-time decay curve. Serum creatinine (SCr) measurement is inexpensive and is part of the routine biochemical blood tests that are commonly requested in daily clinical practice. SCr-based estimated GFR is therefore still the most widely used test to obtain information on kidney function, although SCr varies with age and sex during childhood and GFR remains nearly constant over the 2-18-year age range. These issues are partially resolved by factoring SCr by height, or rescaling SCr by the median of healthy subjects, making interpretation of SCr and eGFR more straightforward. Cystatin C has become an interesting alternative kidney biomarker, and estimating GFR from cystatin C has therefore become more important. The aim of this review is to show recent advances in measuring and estimating GFR in children.</p>","PeriodicalId":19735,"journal":{"name":"Pediatric Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00467-025-06724-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Glomerular filtration rate (GFR) can be measured directly, or estimated from biomarkers like serum creatinine and cystatin C, or both. Measuring GFR in children is cumbersome, as it requires the intravenous injection of an exogenous filtration marker like iohexol, and several blood samples to determine the concentration-time decay curve. Serum creatinine (SCr) measurement is inexpensive and is part of the routine biochemical blood tests that are commonly requested in daily clinical practice. SCr-based estimated GFR is therefore still the most widely used test to obtain information on kidney function, although SCr varies with age and sex during childhood and GFR remains nearly constant over the 2-18-year age range. These issues are partially resolved by factoring SCr by height, or rescaling SCr by the median of healthy subjects, making interpretation of SCr and eGFR more straightforward. Cystatin C has become an interesting alternative kidney biomarker, and estimating GFR from cystatin C has therefore become more important. The aim of this review is to show recent advances in measuring and estimating GFR in children.
期刊介绍:
International Pediatric Nephrology Association
Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.