PROSPECTIVE EVALUATION OF 10 METHODS FOR ESTIMATING CREATININE CLEARANCE IN CHILDREN WITH VARYING DEGREES OF RENAL DYSFUNCTION

The objective of this study was to evaluate ten methods for calculating creatinine clearance (Clcr) in children with renal dysfunction. The design was a prospective, comparative study using 24-h urinary Clcr as the criterion standard. Twenty-two children (age 7-16 years old) were studied. Urinary Clcr ranged from 0 to 161 ml/min/1.73 m(2). Calculated Clcr and 24-h urinary Clcr were evaluated statistically. Linear regression analysis, nominal frequency, and mean relative error were used to rank the methods. Children were stratified based on gender and renal function. None of the methods correlated well when Clcr > 100 ml/min/1.73 m(2). Predictive performance deteriorated as Clcr decreased. Simple methods using height and serum creatinine were best. Clcr (ml/min/1.73 m(2))=(0.52 x height (cm)/serum creatinine) - 3.6 was the best equation for estimating Clcr in our patient population consisting of children over 7 years of age with stable serum creatinine.