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Abstract
Background: Serum creatinine is the most widely used marker for estimating glomerular filtration rate (GFR). The aim of this study was to determine pediatric reference values for serum creatinine levels and eGFR values using data from a population-based study in Iran.
Methods: Serum creatinine of 1594 subjects, aged 3-18 years, participating in phase 4 of the Tehran Lipid and Glucose Study (2008 - 2011 ) was measured using the conventional Jaffe method. The non-parametric method of Schwartz and Counahan-Barratt equations were used to calculate eGFR. CLSI/IFCC guidelines were used to determine reference values.
Results: In both genders, serum creatinine concentration was significantly increased with age and had a positive correlation with age (b oys (r = 0.786, n = 778, P < 0.001 ) and girls (r = 0.638, n = 724, P < 0.001 )). In addition, mean serum creatinine concentration was significantly higher in boys, compared to girls (0.86 ± 0.01 vs. 0.80 ± 0.01 mg/dL, P < 0.001). Based on these results, we proposed the following formula: serum creatinine (mg/dL) = k * age (year) + 0.5, where k was 0.03 for boys and 0.02 for girls.
Conclusions: This study presents pediatric reference values in Iranian boys and girls for serum creatinine levels to be 0.6 - 1.20 mg/dL and 0.6 - 1.00 mg/dL and for eGFR values to be 81 - 154 mL/min/1.73 m2 and 80-129 mL/min/1.73 m2, respectively. These values can be used for diagnostic and therapeutic purposes.
Keywords: Child, Jaffe, reference values, serum creatinine
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Introduction
Chronic kidney disease (CKD) is a growing public health problem throughout the world.1 An annual incidence of over 2% has been reported for CKD among the Iranian population.2 In addition, the prevalence of pediatric CKD is higher in Iran, compared to Western countries.3 Estimated glomerular filtration rate (eGFR) could be used for classification of CKD and adjustment in drug dosage.4
Serum creatinine is the most widely used marker for estimating GFR,5 which is the best index of renal function.6-8 Estimating GFR from serum creatinine has been emphasized by members of NKF CKD (National Kidney Foundation chronic kidney disease), and their recommended equations are Schwartz and CounahanBarratt formulas.9
Compared to the Jaffe method for serum creatinine measurement,...