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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
  • Dubourg, Laurence, hospices civils de Lyon -Université Claude Bernard Lyon 1-INSERM U 820, LYON, France
  • Hansson, Sverker, Sahlgrenska University Hospital, Göteborg, Sweden
  • Drube, Jens, Hannover Medical School, Hannover, Germany
  • Pape, Lars, Hannover Medical School, Hannover, Germany
  • Schäffler, Katharina, numares AG, Regensburg, Germany
  • Steinle, Tobias, numares AG, Regensburg, Germany
  • Fruth, Jana, numares AG, Regensburg, Germany
  • Höckner, Sebastian, numares AG, Regensburg, Germany
  • Schiffer, Eric, numares AG, Regensburg, Germany
Background

Estimation of glomerular filtration rate (eGFRcreat) 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 (GFRNMR) spectroscopy-based biomarker constellation (creatinine, myo-inositol, valine, and dimethyl sulfone) was developed. This method outperformed the conventional eGFRcreat 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 eGFRcreat 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 eGFRcreat (r=0.85 vs. r=0.80). Moreover, the RMSE was reduced from 35.5 for eGFRcreat to 21.6 for GFRNMR. The NMR biomarker constellation also showed a higher accuracy in mGFR prediction with a P30 of 79.5 % compared to 71.8 % for eGFRcreat.

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, GFRNMR 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