Glomerular filtration rate in children with juvenile idiopathic arthritis




juvenile idiopathic arthritis, glomerular filtration rate


Today, it is proved that kidney injury in children with juvenile idiopathic arthritis (JIA) is characterized by a subclinical course and most often remains undiagnosed. One of the main me­thods to diagnose kidney lesions is determination of estimated glomerular filtration rate (eGFR). The aim of the study was to determine the most optimal method for eGFR evaluation in children with JIA by comparing different calculation methods based on serum creatinine (original Schwartz formula, Counahan-Barratt formula), serum cystatin C (cystatin C-based equation and Hoek formula). Materials and methods. Eighty children with JIA were examined. Serum creatinine level was determined twice (first and third month of study) by the colorimetric kinetic Jaffe reaction, serum cystatin C concentration was evaluated once, in the third month of the study by enzyme immunoassay. We used methods of variation statistics. Results. Parameters of eGFR by cystatin C-based equation 2012 compared to the original Schwartz formula and Counahan-Barratt formula amplified the rate of eGFR disorders by 81.3 % (p < 0.001) and 47.3 % (p < 0.001) in the first month of the study and by 81.3 % (p < 0.001) and 55.0 % (p < 0.001) in the third month, respectively. A similar comparison of the results of Hoek formula with Schwartz and Counahan-Barratt formula showed that according to Schwartz formula, a decrease in the GFR was 41.3 % less frequent (p < 0.001) in both the first and third month. Counahan-Barratt formula in the first study of serum creatinine showed a difference in eGFR compared to Hoek formula by 7.5 % (p < 0.05). During the second study of serum creatinine, the frequency of eGFR reduction according to Counahan-Barratt formula was detected by 15.0 % less often than according to Hoek method (p < 0.09). Conclusions. Changes in renal function differ depending on the formula of eGFR evaluation. The most optimal method to determine eGFR in children with JIA is Hoek formula based on serum cystatin C. In case of limited ability to analyze serum cystatin C, Counahan-Barratt formula based on serum creatinine can be used.


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Okamoto N, Yokota S, Takei S, et al. Clinical practice guidance for juvenile idiopathic arthritis (JIA) 2018. Mod Rheumatol. 2019 Jan;29(1):41-59. doi:10.1080/14397595.2018.1514724.

Borysova TP, Samsonenko SV, Badogina LP. On the issue of secondary renal amyloidosis in juvenile rheumatoid arthritis in children. Zdorov`e rebenka. 2020;(15)4:252-257. doi:10.22141/2224-0551.15.4.2020.208477. (in Russian).

Borysova TP, Samsonenko SV, Vakulenko LI, Makoviichuk OA. Glomerular renal lesions in children with juvenile rheumatoid arthritis (literature review). Počki. 2021;10(1):42-47. doi:10.22141 / 2307-1257.10.1.2021.227210. (in Russian).

Becker-Cohen R, Frishberg Y. Severe reversible renal failure due to naproxen-associated acute interstitial nephritis. Eur J Pediatr. 2001 May;160(5):293-295. doi:10.1007/s004310100729.

Mori S, Yoshitama T, Hirakata N, Ueki Y. Prevalence of and factors associated with renal dysfunction in rheumatoid arthritis patients: a cross-sectional study in community hospitals. Clin Rheumatol. 2017 Dec;36(12):2673-2682. doi:10.1007/s10067-017-3804-5.

Gicchino MF, Di Sessa A, Guarino S, et al. Prevalence of and factors associated to chronic kidney disease and hypertension in a cohort of children with juvenile idiopathic arthritis. Eur J Pediatr. 2021 Feb;180(2):655-661. doi:10.1007/s00431-020-03792-4.

Conkar S, Mir S, Karaslan FN, Hakverdi G. Comparing different estimated glomerular filtration rate equations in assessing glomerular function in children based on creatinine and cystatin C. J Clin Lab Anal. 2018 Jul;32(6):e22413. doi:10.1002/jcla.22413.

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl;3(1):1-150.

Qiu X, Liu C, Ye Y, et al. The diagnostic value of serum creatinine and cystatin c in evaluating glomerular filtration rate in patients with chronic kidney disease: a systematic literature review and meta-analysis. Oncotarget. 2017 Aug 16;8(42):72985-72999. doi:10.18632/oncotarget.20271.

Björk J, Nyman U, Berg U, et al. Validation of standardized creatinine and cystatin C GFR estimating equations in a large multicentre European cohort of children. Pediatr Nephrol. 2019 Jun;34(6):1087-1098. doi:10.1007/s00467-018-4185-y.

Ringold S, Angeles-Han ST, Beukelman T, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis. Arthritis Care Res (Hoboken). 2019 Jun;71(6):717-734. doi:10.1002/acr.23870.

Nordal EB, Zak M, Berntson L, et al. Juvenile Arthritis Disease Activity Score (JADAS) based on CRP; validity and predictive ability in a Nordic population-based setting. Pediatr Rheumatol. 2011;9(1):155. doi:10.1186/1546-0096-9-S1-P155.

Miyamae T, Tani Y, Kishi T, Yamanaka H, Singh G. Updated version of Japanese Childhood Health Assessment Questionnaire (CHAQ). Mod Rheumatol. 2020 Sep;30(5):905-909. doi:10.1080/14397595.2019.1660027.

Moore JF, Sharer JD. Methods for Quantitative Creatinine Determination. Curr Protoc Hum Genet. 2017 Apr 6;93:A.3O.1-A.3O.7. doi:10.1002/cphg.38.

Song P, Wang M, Chang X, Wang J, Wei W, An L. Prevalence and associated factors of impaired renal function in Chinese children: The China Health and Nutrition Survey. Nephrology (Carlton). 2019 Feb;24(2):195-201. doi:10.1111/nep.13178.

Padgett D, Ostrenga A, Lepard L. Comparison of methods of estimating creatinine clearance in pediatric patients. Am J Health Syst Pharm. 2017 Jun 1;74(11):826-830. doi:10.2146/ajhp151004.

Salvador CL, Tøndel C, Rowe AD, et al. Estimating glomerular filtration rate in children: evaluation of creatinine- and cystatin C-based equations. Pediatr Nephrol. 2019 Feb;34(2):301-311. doi:10.1007/s00467-018-4067-3.

Kushnirenko SV. 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. 2019;6(102):12-17. doi:10.15574/SP.2019.102.12. (in Ukrainian).

Selistre L, De Souza V, Cochat P, et al. GFR estimation in adolescents and young adults. J Am Soc Nephrol. 2012 Jun;23(6):989-996. doi:10.1681/ASN.2011070705.

Fadrowski JJ, Neu AM, Schwartz GJ, Furth SL. Pediatric GFR estimating equations applied to adolescents in the general population. Clin J Am Soc Nephrol. 2011 Jun;6(6):1427-1435. doi:10.2215/CJN.06460710.

Conkar S, Mir S, Karaslan FN, Hakverdi G. Comparing different estimated glomerular filtration rate equations in assessing glomerular function in children based on creatinine and cystatin C. J Clin Lab Anal. 2018 Jul;32(6):e22413. doi:10.1002/jcla.22413.

Grubb A, Nyman U, Björk J, et al. Simple cystatin C-based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the Counahan-Barratt prediction equations for children. Clin Chem. 2005 Aug;51(8):1420-1431. doi:10.1373/clinchem.2005.051557.

Wagner D, Kniepeiss D, Stiegler P, et al. The assessment of GFR after orthotopic liver transplantation using cystatin C and creatinine-based equations. Transpl Int. 2012 May;25(5):527-536. doi:10.1111/j.1432-2277.2012.01449.x.

Mian AN, Schwartz GJ. Measurement and Estimation of Glomerular Filtration Rate in Children. Adv Chronic Kidney Dis. 2017 Nov;24(6):348-356. doi:10.1053/j.ackd.2017.09.011.

Schwartz GJ, Schneider MF, Maier PS, et al. Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C. Kidney Int. 2012 Aug;82(4):445-453. doi:10.1038/ki.2012.169.

Huang SH, Macnab JJ, Sontrop JM, et al. Performance of the creatinine-based and the cystatin C-based glomerular filtration rate (GFR) estimating equations in a heterogenous sample of patients referred for nuclear GFR testing. Transl Res. 2011 Jun;157(6):357-367. doi:10.1016/j.trsl.2011.01.002.



How to Cite

Borysova, T., & Samsonenko, S. (2022). Glomerular filtration rate in children with juvenile idiopathic arthritis. CHILD`S HEALTH, 17(1), 1–6.



Clinical Pediatrics

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