Kidney Week

Abstract: TH-PO752

Novel Nuclear Magnetic Resonance-Based Method for Prediction of Glomerular Filtration Rate Performs Well in Children

Session Information

• Pediatric CKD
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1700 Pediatric Nephrology

Authors

• Ehrich, Jochen H.h., Hannover Medical School, Hannover, Germany

Jochen H.h. Ehrich,

• Dubourg, Laurence, hospices civils de Lyon -Université Claude Bernard Lyon 1-INSERM U 820, LYON, France

Laurence Dubourg,

• Hansson, Sverker, Sahlgrenska University Hospital, Göteborg, Sweden

Sverker Hansson,

• Drube, Jens, Hannover Medical School, Hannover, Germany

Jens Drube,

• Pape, Lars, Hannover Medical School, Hannover, Germany

Lars Pape,

• Schäffler, Katharina, numares AG, Regensburg, Germany

Katharina Schäffler,

• Steinle, Tobias, numares AG, Regensburg, Germany

Tobias Steinle,

• Fruth, Jana, numares AG, Regensburg, Germany

Jana Fruth,

• Höckner, Sebastian, numares AG, Regensburg, Germany

Sebastian Höckner,

• Schiffer, Eric, numares AG, Regensburg, Germany

Eric Schiffer,

Background

Estimation of glomerular filtration rate (eGFR_creat) in children requires different equations than in adults. This led to the development of different pediatric equations; however, these equations still show suboptimal performances in the upper and lower GFR range. Recently, a novel serum-based method for accurate prediction of GFR using a nuclear magnetic resonance (GFR_NMR) spectroscopy-based biomarker constellation (creatinine, myo-inositol, valine, and dimethyl sulfone) was developed. This method outperformed the conventional eGFR_creat equations when validated in three separate cohorts of predominantly adult patients.

Methods

The value of the NMR-based biomarker constellation for GFR prediction specifically in children was investigated by testing its performance in a cohort of 39 children (20 girls, 19 boys) aged between 2 and 17 years. The NMR-based method was compared to eGFR_creat obtained by the bedside Schwartz equation using measured GFR (mGFR) as reference standard. Pearson correlation coefficient (r) with 95 % confidence interval, root mean square error (RMSE), and the percentage of eGFR values within 30% of measured GFR (P30) were calculated to assess the accuracy of the methods.

Results

In a cohort comprising pediatric patients with various degrees of kidney impairment covering the whole GFR range, the NMR-based method showed a higher correlation with mGFR compared to eGFR_creat (r=0.85 vs. r=0.80). Moreover, the RMSE was reduced from 35.5 for eGFR_creat to 21.6 for GFR_NMR. The NMR biomarker constellation also showed a higher accuracy in mGFR prediction with a P30 of 79.5 % compared to 71.8 % for eGFR_creat.

Conclusion

Our results demonstrate that the NMR-based biomarker constellation accurately predicts GFR not only in adults but also in pediatric patients. In fact, the novel method outperformed the established bedside Schwartz equation. Thus, GFR_NMR allows reliable and continuous monitoring of kidney function at the transition from pediatric to adult renal care without the need to switch the estimation equation.

Funding

• Commercial Support –