Estimated pediatric glomerular filtration rate presentation improves the detection rate of kidney impairment in children.

ABSTRACT

BACKGROUND: Accurate interpretation of everyday laboratory work is crucial for the early detection of impaired kidney function. Bedside estimation of glomerular filtration rate (eGFR) in children is based on serum creatinine standardized for body mass, most commonly using the revised Schwartz equation using height. This study evaluates how data presentation affects the correct assessment of children's kidney function. METHODS: In this survey-based study, 121 physicians treating children routinely in a tertiary hospital answered 11 clinical questions requiring assessment of kidney function based on serum creatinine with general (adult) or pediatric normal serum creatinine ranges, or by presented eGFR. The demographic data of the participants were collected. RESULTS: Presenting eGFR values rather than the customary presentation of serum creatinine and anthropometric parameters more than quadrupled the number of physicians who accurately estimated pediatric kidney function; 38.8% of physicians correctly assessed kidney function when presented with eGFR values but misinterpreted it when equivalent creatinine values were presented (p < 0.001). Seniority, specialty, and self-reported frequency of pediatric kidney function assessment did not affect the interpretation. CONCLUSIONS: Presenting physicians with calculated eGFR can dramatically improve the ability of the medical team to assess kidney function correctly in children. A higher resolution version of the Graphical abstract is available as Supplementary information.