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Article |

Serum Creatinine Level and Renal Function in Children

James E. Springate, MD; Steven L. Christensen, MD; Leonard G. Feld, MD, PhD
Am J Dis Child. 1992;146(10):1232-1235. doi:10.1001/archpedi.1992.02160220118036.
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• Objective.  —To evaluate the accuracy of serum creatinine and height/serum creatinine glomerular filtration rate (CrGFR) formula as screening tests for abnormal renal function defined by plasma diethylenetriaminepenta-acetic acid (DTPA) clearance.

Design.  —Patient series.

Setting.  —The Children's Hospital of Buffalo (NY).

Patients.  —Eighty-seven consecutive patients ranging in age from 2 to 20 years.

Measurements.  —The Cr-GFR was calculated by means of the formula GFR (milliliters per minute per 1.73 m2)=kl/serum creatinine (milligrams per deciliter), where L is body length in centimeters and k is a constant dependent on age and sex. Plasma clearance of technetium Tc 99m-labeled DTPA was our reference method for determination of GFR (DTPA-GFR).

Results.  —The Cr-GFR formula identified children with impaired renal function (DTPA clearance, <80 mL/min per 1.73 m2) with a sensitivity of 95% and a specificity of 93%. In contrast, the sensitivity and specificity of elevated serum creatinine level for this purpose were 80% and 96%, respectively. Of the children with renal insufficiency (DTPA clearance, 40 to 79 mL/min per 1.73 m2), 91% were correctly identified by the Cr-GFR formula. However, only 65% of these children had elevated serum creatinine levels. Although all children with renal failure (DTPA clearance, <40 mL/min per 1.73 m2) had abnormally high serum creatinine levels, the specificity of this test was significantly lower than that of the Cr-GFR formula (75% vs 100%, respectively).

Conclusions.  —The Cr-GFR formula is superior to serum creatinine level for estimating GFR. This formula provides a simple, reasonably accurate screening test for the presence and severity of impaired renal function.(AJDC. 1992;146:1232-1235)


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