Modern Pediatrics.Ukraine.2019.6(102):12-17; doi 10.15574/SP.2019.102.12
S.V. Kushnirenko
Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

For citation: Kushnirenko SV. (2019). Cystatin C – based evaluation of the estimated glomerular filtration rate in children with chronic kidney disease 1–3 st. (3а and 3b). Modern Pediatrics.Ukraine. 6(102): 12–17. doi 10.15574/SP.2019.102.12
Article received: May 16, 2019. Accepted for publication: Oct 04, 2019.

Objective: to evaluate the estimated glomerular filtration rate (GFR) based on the cystatin C (CsC) serum concentration (eGFRc) in children with chronic kidney disease (CKD) 1–3 st. (3a and 3b) using the equations of F.J. Hoek, M. Zappitelli and Pediatric GFR Calculator — NKF.
Materials and methods. CsC serum concentration was determined and GFR was calculated in 132 children aged 2 to 17 with CKD 1–3 st. (3a and 3b) using the equations of F.J. Hoek, M. Zappitelli and Pediatric GFR Calculator – NKF.
Results. CsC blood serum concentration values in children with CKD 3a st. (1.41±0.03 mg/l) and CKD 3b st. (1.97±0.1 mg/l) corresponded to the same eGFRc obtained at each of the sub-stages by equations of M. Zappitelli, F.J. Hoek, Pediatric GFR Calculator – NKF, in contrast to patients with CKD 1 st., in which eGFRc according to Pediatric GFR Calculator NKF in 62.7% of patients decreased the GFR below 90 ml/min/1.73m², potentially transferring them into CKD 2 st. A comparative analysis of eGFRc made in patients with CKD 3a st. and CKD 3b st. showed a significant difference between the sub-stages when calculated using the three equations (p<0.001) and as compared to the combined option of CKD 3 st. and CKD 1–2 st. (p<0.01, p<0.001), respectively, which proves that it is reasonable and necessity to divide CKD 3 st. into sub-stages 3a and 3b. A regression analysis made for the whole set of patients included in the study allowed to establish that there is a high-degree correlation between the values and the inverse correlation dependence of eGFRc on the CsC level by equations of F.J. Hoek, M. Zappitelli or Pediatric GFR Calculator — NKF (r=-0.93; r=-0.92; r=-0.94, respectively).
Conclusions. eGFRc evaluation based on CsC serum concentration in children with CKD 1–3 st. (3a and 3b) confirmed that it is reasonable to divide CKD 3 st. into sub-stages 3a st. and 3b st. in the pediatric population.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of Kyiv City Children's Clinical Hospital No. 1. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest were declared by the authors.
Key words: cystatin C, estimated glomerular filtration rate, children, chronic kidney disease.

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