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Article ; Online: Is there an age cutoff to apply adult formulas for GFR estimation in children?

Azzi, Antonio / Cachat, Francois / Faouzi, Mohamed / Mosig, Dolores / Ramseyer, Pascal / Girardin, Eric / Chehade, Hassib

Journal of nephrology

2014 Volume 28, Issue 1, Page(s) 59–66

Abstract: Background: Estimation of glomerular filtration rate (eGFR) using a common formula for both adult and pediatric populations is challenging. Using inulin clearances (iGFRs), this study aims to investigate the existence of a precise age cutoff beyond ... ...

Abstract	Background: Estimation of glomerular filtration rate (eGFR) using a common formula for both adult and pediatric populations is challenging. Using inulin clearances (iGFRs), this study aims to investigate the existence of a precise age cutoff beyond which the Modification of Diet in Renal Disease (MDRD), the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), or the Cockroft-Gault (CG) formulas, can be applied with acceptable precision. Performance of the new Schwartz formula according to age is also evaluated. Method: We compared 503 iGFRs for 503 children aged between 33 months and 18 years to eGFRs. To define the most precise age cutoff value for each formula, a circular binary segmentation method analyzing the formulas' bias values according to the children's ages was performed. Bias was defined by the difference between iGFRs and eGFRs. To validate the identified cutoff, 30% accuracy was calculated. Results: For MDRD, CKD-EPI and CG, the best age cutoff was ≥14.3, ≥14.2 and ≤10.8 years, respectively. The lowest mean bias and highest accuracy were -17.11 and 64.7% for MDRD, 27.4 and 51% for CKD-EPI, and 8.31 and 77.2% for CG. The Schwartz formula showed the best performance below the age of 10.9 years. Conclusion: For the MDRD and CKD-EPI formulas, the mean bias values decreased with increasing child age and these formulas were more accurate beyond an age cutoff of 14.3 and 14.2 years, respectively. For the CG and Schwartz formulas, the lowest mean bias values and the best accuracies were below an age cutoff of 10.8 and 10.9 years, respectively. Nevertheless, the accuracies of the formulas were still below the National Kidney Foundation Kidney Disease Outcomes Quality Initiative target to be validated in these age groups and, therefore, none of these formulas can be used to estimate GFR in children and adolescent populations.
MeSH term(s)	Adolescent ; Age Factors ; Bias ; Child ; Child, Preschool ; Female ; Glomerular Filtration Rate ; Humans ; Inulin/blood ; Inulin/urine ; Male ; Mathematical Concepts ; Models, Statistical
Chemical Substances	Inulin (9005-80-5)
Language	English
Publishing date	2014-10-07
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-014-0148-y
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Zs.A 3369: Show issues

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Article ; Online: Calorie Restriction in Adulthood Reduces Hepatic Disorders Induced by Transient Postnatal Overfeeding in Mice.

Yzydorczyk, Catherine / Li, Na / Rigal, Eve / Chehade, Hassib / Mosig, Dolores / Armengaud, Jean Baptiste / Rolle, Thibaud / Krishnasamy, Anithan / Orozco, Eulalia / Siddeek, Benazir / Juvet, Christian / Vergely, Catherine / Simeoni, Umberto

Nutrients

2019 Volume 11, Issue 11

Abstract: Impaired early nutrition influences the risk of developing metabolic disorders in later life. We observed that transient postnatal overfeeding (OF) in mice induces long-term hepatic alterations, characterized by microsteatosis, fibrosis associated with ... ...

Abstract	Impaired early nutrition influences the risk of developing metabolic disorders in later life. We observed that transient postnatal overfeeding (OF) in mice induces long-term hepatic alterations, characterized by microsteatosis, fibrosis associated with oxidative stress (OS), and stress-induced premature senescence (SIPS). In this study, we investigated whether such changes can be reversed by moderate calorie restriction (CR). C57BL/6 male mice pups were maintained during lactation in litters adjusted to nine pups in the normal feeding (NF) group and three pups in the transient postnatal OF group. At six months of age, adult mice from the NF and OF groups were randomly assigned to an
MeSH term(s)	Animals ; Animals, Newborn ; Caloric Restriction/methods ; Catalase/metabolism ; Cellular Senescence ; Feeding Methods/adverse effects ; Female ; Liver/metabolism ; Liver Diseases/diet therapy ; Liver Diseases/etiology ; Liver Diseases/physiopathology ; Male ; Mice ; Mice, Inbred C57BL ; Oxidative Stress ; Superoxide Dismutase/metabolism
Chemical Substances	Catalase (EC 1.11.1.6) ; Superoxide Dismutase (EC 1.15.1.1)
Language	English
Publishing date	2019-11-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu11112796
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Article: Calorie Restriction in Adulthood Reduces Hepatic Disorders Induced by Transient Postnatal Overfeeding in Mice

Nutrients. 2019 Nov. 16, v. 11, no. 11

2019

Abstract	Impaired early nutrition influences the risk of developing metabolic disorders in later life. We observed that transient postnatal overfeeding (OF) in mice induces long-term hepatic alterations, characterized by microsteatosis, fibrosis associated with oxidative stress (OS), and stress-induced premature senescence (SIPS). In this study, we investigated whether such changes can be reversed by moderate calorie restriction (CR). C57BL/6 male mice pups were maintained during lactation in litters adjusted to nine pups in the normal feeding (NF) group and three pups in the transient postnatal OF group. At six months of age, adult mice from the NF and OF groups were randomly assigned to an ad libitum diet or CR (daily energy supply reduced by 20%) for one month. In each group, at the age of seven months, analysis of liver structure, liver markers of OS (superoxide anion, antioxidant defenses), and SIPS (lipofuscin, p53, p21, p16, pRb/Rb, Acp53, sirtuin-1) were performed. CR in the OF group reduced microsteatosis, decreased levels of superoxide anion, and increased protein expression of catalase and superoxide dismutase. Moreover, CR decreased lipofuscin staining, p21, p53, Acp53, and p16 but increased pRb/Rb and sirtuin-1 protein expression. CR did not affect the NF group. These results suggest that CR reduces hepatic disorders induced by OF.
Keywords	adulthood ; adults ; antioxidant activity ; catalase ; energy ; fibrosis ; lactation ; liver ; low calorie diet ; males ; metabolic diseases ; mice ; nutrition risk assessment ; overfeeding ; oxidative stress ; protein synthesis ; pups ; staining ; superoxide anion ; superoxide dismutase
Language	English
Dates of publication	2019-1116
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article
ZDB-ID	2518386-2
ISSN	2072-6643
ISSN	2072-6643
DOI	10.3390/nu11112796
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Urinary low-molecular-weight protein excretion in pediatric idiopathic nephrotic syndrome.

Chehade, Hassib / Parvex, Paloma / Poncet, Antoine / Werner, Dominique / Mosig, Dolores / Cachat, Francois / Girardin, Eric

Pediatric nephrology (Berlin, Germany)

2013 Volume 28, Issue 12, Page(s) 2299–2306

Abstract: Background: Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are the most common causes of idiopathic nephrotic syndrome (INS). We have evaluated the reliability of urinary neutrophil-gelatinase-associated lipocalin (uNGAL), ... ...

Abstract	Background: Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are the most common causes of idiopathic nephrotic syndrome (INS). We have evaluated the reliability of urinary neutrophil-gelatinase-associated lipocalin (uNGAL), urinary alpha1-microglobulin (uα1M) and urinary N-acetyl-beta-D-glucosaminidase (uβNAG) as markers for differentiating MCD from FSGS. We have also evaluated whether these proteins are associated to INS relapses or to glomerular filtration rate (GFR). Methods: The patient cohort comprised 35 children with MCD and nine with FSGS; 19 healthy age-matched children were included in the study as controls. Of the 35 patients, 28 were in remission (21 MCD, 7 FSGS) and 16 were in relapse (14 MCD, 2 FSGS). The prognostic accuracies of these proteins were assessed by receiver operating characteristic (ROC) curve analyses. Results: The level of uNGAL, indexed or not to urinary creatinine (uCreat), was significantly different between children with INS and healthy children (p = 0.02), between healthy children and those with FSGS (p = 0.007) and between children with MCD and those with FSGS (p = 0.01). It was not significantly correlated to proteinuria or GFR levels. The ROC curve analysis showed that a cut-off value of 17 ng/mg for the uNGAL/uCreat ratio could be used to distinguish MCD from FSGS with a sensitivity of 0.77 and specificity of 0.78. uβNAG was not significantly different in patients with MCD and those with FSGS (p = 0.86). Only uα1M, indexed or not to uCreat, was significantly (p < 0.001) higher for patients in relapse compared to those in remission. Conclusions: Our results indicate that in our patient cohort uNGAL was a reliable biomarker for differentiating MCD from FSGS independently of proteinuria or GFR levels.
MeSH term(s)	Acetylglucosaminidase/urine ; Acute-Phase Proteins/urine ; Adolescent ; Age Factors ; Alpha-Globulins/urine ; Biomarkers/urine ; Case-Control Studies ; Child ; Child, Preschool ; Creatinine/urine ; Cross-Sectional Studies ; Glomerular Filtration Rate ; Glomerulosclerosis, Focal Segmental/complications ; Glomerulosclerosis, Focal Segmental/diagnosis ; Glomerulosclerosis, Focal Segmental/physiopathology ; Humans ; Kidney/physiopathology ; Lipocalin-2 ; Lipocalins/urine ; Molecular Weight ; Nephrosis, Lipoid/complications ; Nephrosis, Lipoid/diagnosis ; Nephrosis, Lipoid/physiopathology ; Nephrotic Syndrome/diagnosis ; Nephrotic Syndrome/etiology ; Nephrotic Syndrome/physiopathology ; Predictive Value of Tests ; Prospective Studies ; Proteinuria/diagnosis ; Proteinuria/etiology ; Proteinuria/physiopathology ; Proto-Oncogene Proteins/urine ; ROC Curve ; Recurrence
Chemical Substances	Acute-Phase Proteins ; Alpha-Globulins ; Biomarkers ; LCN2 protein, human ; Lipocalin-2 ; Lipocalins ; Proto-Oncogene Proteins ; alpha-1-microglobulin ; Creatinine (AYI8EX34EU) ; Acetylglucosaminidase (EC 3.2.1.52)
Language	English
Publishing date	2013-08-15
Publishing country	Germany
Document type	Evaluation Study ; Journal Article
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-013-2569-6
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Zs.A 2196: Show issues

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Article ; Online: Beneficial effect of insulin-like growth factor-1 on hypoxemic renal dysfunction in the newborn rabbit.

Prévot, Anne / Julita, Monique / Tung, David K / Mosig, Dolores

Pediatric nephrology (Berlin, Germany)

2009 Volume 24, Issue 5, Page(s) 973–981

Abstract: Acute normocapnic hypoxemia can cause functional renal insufficiency by increasing renal vascular resistance (RVR), leading to renal hypoperfusion and decreased glomerular filtration rate (GFR). Insulin-like growth factor 1 (IGF-1) activity is low in ... ...

Abstract	Acute normocapnic hypoxemia can cause functional renal insufficiency by increasing renal vascular resistance (RVR), leading to renal hypoperfusion and decreased glomerular filtration rate (GFR). Insulin-like growth factor 1 (IGF-1) activity is low in fetuses and newborns and further decreases during hypoxia. IGF-1 administration to humans and adult animals induces pre- and postglomerular vasodilation, thereby increasing GFR and renal blood flow (RBF). A potential protective effect of IGF-1 on renal function was evaluated in newborn rabbits with hypoxemia-induced renal insufficiency. Renal function and hemodynamic parameters were assessed in 17 anesthetized and mechanically ventilated newborn rabbits. After hypoxemia stabilization, saline solution (time control) or IGF-1 (1 mg/kg) was given as an intravenous (i.v.) bolus, and renal function was determined for six 30-min periods. Normocapnic hypoxemia significantly increased RVR (+16%), leading to decreased GFR (-14%), RBF (-19%) and diuresis (-12%), with an increased filtration fraction (FF). Saline solution resulted in a worsening of parameters affected by hypoxemia. Contrarily, although mean blood pressure decreased slightly but significantly, IGF-1 prevented a further increase in RVR, with subsequent improvement of GFR, RBF and diuresis. FF indicated relative postglomerular vasodilation. Although hypoxemia-induced acute renal failure was not completely prevented, IGF-1 elicited efferent vasodilation, thereby precluding a further decline in renal function.
MeSH term(s)	Animals ; Animals, Newborn ; Disease Models, Animal ; Hemodynamics/drug effects ; Hypoxia/complications ; Hypoxia/drug therapy ; Injections, Intravenous ; Insulin-Like Growth Factor I/administration & dosage ; Insulin-Like Growth Factor I/pharmacology ; Kidney Diseases/etiology ; Kidney Diseases/mortality ; Kidney Diseases/prevention & control ; Kidney Function Tests ; Longevity/drug effects ; Rabbits ; Renal Circulation/drug effects ; Survival Rate ; Urinalysis ; Vasodilation/drug effects
Chemical Substances	Insulin-Like Growth Factor I (67763-96-6)
Language	English
Publishing date	2009-01-24
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	631932-4
ISSN	1432-198X ; 0931-041X
ISSN (online)	1432-198X
ISSN	0931-041X
DOI	10.1007/s00467-008-1098-1
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Article ; Online: Transient postnatal overfeeding causes liver stress-induced premature senescence in adult mice.

Yzydorczyk, Catherine / Li, Na / Chehade, Hassib / Mosig, Dolores / Bidho, Mickael / Keshavjee, Basile / Armengaud, Jean Baptiste / Nardou, Katya / Siddeek, Benazir / Benahmed, Mohamed / Vergely, Catherine / Simeoni, Umberto

Scientific reports

2017 Volume 7, Issue 1, Page(s) 12911

Abstract: Unbalanced nutrition early in life is increasingly recognized as an important factor in the development of chronic, non-communicable diseases at adulthood, including metabolic diseases. We aimed to determine whether transient postnatal overfeeding (OF) ... ...

Abstract	Unbalanced nutrition early in life is increasingly recognized as an important factor in the development of chronic, non-communicable diseases at adulthood, including metabolic diseases. We aimed to determine whether transient postnatal overfeeding (OF) leads to liver stress-induced premature senescence (SIPS) of hepatocytes in association with liver structure and hepatic function alterations. Litters sizes of male C57BL/6 mice were adjusted to 9 pups (normal feeding, NF) or reduced to 3 pups during the lactation period to induce transient postnatal OF. Compared to the NF group, seven-month-old adult mice transiently overfed during the postnatal period were overweight and developed glucose intolerance and insulin resistance. Their livers showed microsteatosis and fibrosis, while hepatic insulin signaling and glucose transporter protein expressions were altered. Increased hepatic oxidative stress (OS) was observed, with increased superoxide anion production, glucose-6-phosphate dehydrogenase protein expression, oxidative DNA damage and decreased levels of antioxidant defense markers, such as superoxide dismutase and catalase proteins. Hepatocyte senescence was characterized by increased p21
MeSH term(s)	Aging/pathology ; Animals ; Animals, Newborn ; Body Composition ; Body Weight ; DNA Damage ; Female ; Glucose/metabolism ; Glucose Tolerance Test ; Insulin/metabolism ; Liver/metabolism ; Liver/pathology ; Liver Cirrhosis/pathology ; Membrane Transport Proteins/metabolism ; Mice, Inbred C57BL ; Overnutrition/pathology ; Oxidative Stress ; Signal Transduction ; Staining and Labeling ; Stress, Physiological
Chemical Substances	Insulin ; Membrane Transport Proteins ; Glucose (IY9XDZ35W2)
Language	English
Publishing date	2017-10-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-017-11756-2
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Article ; Online: Microalbuminuria and hyperfiltration in subjects with nephro-urological disorders.

Cachat, Francois / Combescure, Christophe / Chehade, Hassib / Zeier, Gregory / Mosig, Dolores / Meyrat, Blaise / Frey, Peter / Girardin, Eric

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

2013 Volume 28, Issue 2, Page(s) 386–391

Abstract: Background: Microalbuminuria (MA) has been shown to be an early biomarker of renal damage. It is postulated that MA is the early result of hyperfiltration, which could evolve into glomerular sclerosis and renal failure if hyperfiltration is left ... ...

Abstract	Background: Microalbuminuria (MA) has been shown to be an early biomarker of renal damage. It is postulated that MA is the early result of hyperfiltration, which could evolve into glomerular sclerosis and renal failure if hyperfiltration is left untreated. We hypothesized that MA is a good indicator of hyperfiltration in children with kidney disorders, obviating the need to calculate the filtration fraction (FF). Methods: A total of 155 children or young adults were prospectively included [42 single kidney (SK), 61 vesico-ureteral reflux, 23 obstructive uropathies, 29 other kidney diseases]. We measured inulin, para-aminohippuric acid clearances, FF and MA. Prediction of hyperfiltration was explored by studying the association between the FF and other variables such as urinary albumin (Alb), urinary albumin-creatinine ratio (ACR) and creatinine clearance. Results: A significant but weak association between urinary Alb or ACR and FF was found in subjects with an SK (Spearman correlation coefficients 0.32 and 0.19, respectively). Multivariate analysis also showed that urinary Alb and ACR significantly predict FF only in subjects with an SK (r(2) = 0.17, P = 0.01 and r(2) = 0.13, P = 0.02, respectively). This holds true only in subjects with an SK and inulin clearance >90 mL/min/1.73 m(2) (r(2) = 0.41, P < 0.001). There was no association between creatinine clearance and FF. Conclusions: MA is not associated with FF in our subjects with nephro-urological disorders, except in those with an SK, where the association is weak, indicating that MA is due to other mechanisms than high FF and cannot predict hyperfiltration in such groups.
MeSH term(s)	Adolescent ; Albuminuria/physiopathology ; Albuminuria/urine ; Biomarkers/urine ; Child ; Creatinine/urine ; Female ; Glomerular Filtration Rate/physiology ; Humans ; Kidney/physiopathology ; Kidney Diseases/physiopathology ; Kidney Diseases/urine ; Male ; Multivariate Analysis ; Predictive Value of Tests ; Prospective Studies ; Urethral Obstruction/physiopathology ; Urethral Obstruction/urine ; Vesico-Ureteral Reflux/physiopathology ; Vesico-Ureteral Reflux/urine
Chemical Substances	Biomarkers ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2013-02
Publishing country	England
Document type	Journal Article
ZDB-ID	90594-x
ISSN	1460-2385 ; 0931-0509
ISSN (online)	1460-2385
ISSN	0931-0509
DOI	10.1093/ndt/gfs494
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Zs.A 2198: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 329: Show issues

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Article ; Online: Comparison of the glomerular filtration rate in children by the new revised Schwartz formula and a new generalized formula.

Gao, Anja / Cachat, Francois / Faouzi, Mohamed / Bardy, Daniel / Mosig, Dolores / Meyrat, Blaise-Julien / Girardin, Eric / Chehade, Hassib

Kidney international

2013 Volume 83, Issue 3, Page(s) 524–530

Abstract: The most widely used formula for estimating glomerular filtration rate (eGFR) in children is the Schwartz formula. It was revised in 2009 using iohexol clearances with measured GFR (mGFR) ranging between 15 and 75 ml/min × 1.73 m(2). Here we assessed the ...

Abstract	The most widely used formula for estimating glomerular filtration rate (eGFR) in children is the Schwartz formula. It was revised in 2009 using iohexol clearances with measured GFR (mGFR) ranging between 15 and 75 ml/min × 1.73 m(2). Here we assessed the accuracy of the Schwartz formula using the inulin clearance (iGFR) method to evaluate its accuracy for children with less renal impairment comparing 551 iGFRs of 392 children with their Schwartz eGFRs. Serum creatinine was measured using the compensated Jaffe method. In order to find the best relationship between iGFR and eGFR, a linear quadratic regression model was fitted and a more accurate formula was derived. This quadratic formula was: 0.68 × (Height (cm)/serum creatinine (mg/dl))-0.0008 × (height (cm)/serum creatinine (mg/dl))(2)+0.48 × age (years)-(21.53 in males or 25.68 in females). This formula was validated using a split-half cross-validation technique and also externally validated with a new cohort of 127 children. Results show that the Schwartz formula is accurate until a height (Ht)/serum creatinine value of 251, corresponding to an iGFR of 103 ml/min × 1.73 m(2), but significantly unreliable for higher values. For an accuracy of 20 percent, the quadratic formula was significantly better than the Schwartz formula for all patients and for patients with a Ht/serum creatinine of 251 or greater. Thus, the new quadratic formula could replace the revised Schwartz formula, which is accurate for children with moderate renal failure but not for those with less renal impairment or hyperfiltration.
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Creatinine/blood ; Cystatin C/blood ; Female ; Glomerular Filtration Rate ; Humans ; Male ; Mathematics
Chemical Substances	Cystatin C ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2013-03
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1038/ki.2012.388
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Zs.A 797: Show issues

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Article ; Online: New combined serum creatinine and cystatin C quadratic formula for GFR assessment in children.

Chehade, Hassib / Cachat, Francois / Jannot, Anne-Sophie / Meyrat, Blaise-Julien / Mosig, Dolores / Bardy, Daniel / Parvex, Paloma / Girardin, Eric

Clinical journal of the American Society of Nephrology : CJASN

2013 Volume 9, Issue 1, Page(s) 54–63

Abstract: Background and objectives: The estimated GFR (eGFR) is important in clinical practice. To find the best formula for eGFR, this study assessed the best model of correlation between sinistrin clearance (iGFR) and the solely or combined cystatin C (CysC)- ... ...

Abstract	Background and objectives: The estimated GFR (eGFR) is important in clinical practice. To find the best formula for eGFR, this study assessed the best model of correlation between sinistrin clearance (iGFR) and the solely or combined cystatin C (CysC)- and serum creatinine (SCreat)-derived models. It also evaluated the accuracy of the combined Schwartz formula across all GFR levels. Design, setting, participants, & measurements: Two hundred thirty-eight iGFRs performed between January 2012 and April 2013 for 238 children were analyzed. Regression techniques were used to fit the different equations used for eGFR (i.e., logarithmic, inverse, linear, and quadratic). The performance of each model was evaluated using the Cohen κ correlation coefficient and the percentage reaching 30% accuracy was calculated. Results: The best model of correlation between iGFRs and CysC is linear; however, it presents a low κ coefficient (0.24) and is far below the Kidney Disease Outcomes Quality Initiative targets to be validated, with only 84% of eGFRs reaching accuracy of 30%. SCreat and iGFRs showed the best correlation in a fitted quadratic model with a κ coefficient of 0.53 and 93% accuracy. Adding CysC significantly (P<0.001) increased the κ coefficient to 0.56 and the quadratic model accuracy to 97%. Therefore, a combined SCreat and CysC quadratic formula was derived and internally validated using the cross-validation technique. This quadratic formula significantly outperformed the combined Schwartz formula, which was biased for an iGFR≥91 ml/min per 1.73 m(2). Conclusions: This study allowed deriving a new combined SCreat and CysC quadratic formula that could replace the combined Schwartz formula, which is accurate only for children with moderate chronic kidney disease.
MeSH term(s)	Adolescent ; Age Factors ; Biomarkers/blood ; Child ; Child, Preschool ; Creatinine/blood ; Cystatin C/blood ; Female ; Glomerular Filtration Rate ; Humans ; Kidney/physiopathology ; Linear Models ; Logistic Models ; Male ; Models, Cardiovascular ; Predictive Value of Tests ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/physiopathology ; Reproducibility of Results ; Severity of Illness Index
Chemical Substances	Biomarkers ; CST3 protein, human ; Cystatin C ; Creatinine (AYI8EX34EU)
Language	English
Publishing date	2013-11-07
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Validation Study
ZDB-ID	2226665-3
ISSN	1555-905X ; 1555-9041
ISSN (online)	1555-905X
ISSN	1555-9041
DOI	10.2215/CJN.00940113
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Zs.A 6584: Show issues

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Article: The effects of losartan on renal function in the newborn rabbit.

Prevot, Anne / Mosig, Dolores / Guignard, Jean-Pierre

Pediatric research

2002 Volume 51, Issue 6, Page(s) 728–732

Abstract: The low GFR of newborns is maintained by various factors including the renin-angiotensin system. We previously established the importance of angiotensin II in the newborn kidney, using the angiotensin-converting enzyme inhibitor perindoprilat. The ... ...

Abstract	The low GFR of newborns is maintained by various factors including the renin-angiotensin system. We previously established the importance of angiotensin II in the newborn kidney, using the angiotensin-converting enzyme inhibitor perindoprilat. The present study was designed to complement these observations by evaluating the role of angiotensin-type 1 (AT(1)) receptors, using losartan, a specific AT(1)-receptor blocker. Increasing doses of losartan were infused into anesthetized, ventilated, newborn rabbits. Renal function and hemodynamic variables were assessed using inulin and para-aminohippuric acid clearances as markers of GFR and renal plasma flow, respectively. Losartan 0.1 mg/kg slightly decreased mean blood pressure (-11%) and increased diuresis (+22%). These changes can be explained by inhibition of the AT(1)-mediated vasoconstrictive and antidiuretic effects of angiotensin, and activation of vasodilating and diuretic AT(2) receptors widely expressed in the neonatal period. GFR and renal blood flow were not modified. Losartan 0.3 mg/kg decreased mean blood pressure significantly (-15%), probably by inhibiting systemic AT(1) receptors. GFR significantly decreased (-25%), whereas renal blood flow remained stable. The decrease in filtration fraction (-21%) indicates predominant efferent vasodilation. At 3 mg/kg, the systemic hypotensive effect of losartan was marked (mean blood pressure, -28%), with decreased GFR and renal blood flow (-57% and -51%, respectively), a stable filtration fraction, and an increase in renal vascular resistance by 124%. The renal response to this dose can be considered as reflex vasoconstriction of afferent and efferent arterioles, rather than specific receptor antagonism. We conclude that under physiologic conditions, the renin-angiotensin is critically involved in the maintenance of GFR in the immature kidney.
MeSH term(s)	Angiotensin Receptor Antagonists ; Animals ; Animals, Newborn ; Antihypertensive Agents/pharmacology ; Blood Pressure/drug effects ; Blood Proteins ; Carbon Dioxide/blood ; Glomerular Filtration Rate/drug effects ; Heart Rate/drug effects ; Hematocrit ; Losartan/pharmacology ; Oxygen/blood ; Rabbits ; Receptor, Angiotensin, Type 1
Chemical Substances	Angiotensin Receptor Antagonists ; Antihypertensive Agents ; Blood Proteins ; Receptor, Angiotensin, Type 1 ; Carbon Dioxide (142M471B3J) ; Losartan (JMS50MPO89) ; Oxygen (S88TT14065)
Language	English
Publishing date	2002-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	4411-8
ISSN	1530-0447 ; 0031-3998
ISSN (online)	1530-0447
ISSN	0031-3998
DOI	10.1203/00006450-200206000-00011
Database	MEDical Literature Analysis and Retrieval System OnLINE

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