Estimation of glomerular filtration rate in anorectic adolescents

L. P. Brion, M. A. Boeck, B. Gauthier, M. P. Nussbaum, G. J. Schwartz

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

Severe malnutrition has been associated with a decrease in fat and lean body mass, as well as in renal function. This study was designed to evaluate the estimation of glomerular filtration rate (GFR, ml/min per 1.73 m2) in malnourished teenagers, by using the formula GFR=k L/Pcr (where L is body height, Pcr is plasma creatinine concentration and k is a proportionality constant relating muscle mass to body size that has been found to equal 0.7 in adolescent boys and 0.55 in girls). Body composition was estimated using anthropometric measurements and urinary creatinine excretion (UcrV). Malnourished female patients showed depletion of fat and muscle, whereas males had primarily decreased muscle mass. There was a good correlation (r=0.74) between anthropometric [arm muscle volume (AMV)] and chemical UcrV estimates of muscle mass. However, our previously validated estimate of GFR did not give reliable results in this group of malnourished teenagers, probably because their muscle mass was so greatly altered by the severity of malnutrition. Therefore, we used anthropometric measurements and Pcr, to estimate GFR by multiple linear regression. The best prediction was obtained by using AMV/Pcr and the observed/expected (for age, height and sex) weight ratio (WR): {Mathematical expression} We confirm that malnutrition in adolescents is associated with decreased GFR and conclude that the resulting variability in body composition limits the possibility of estimating GFR from Pcr and height. A somewhat better estimate may be obtained from simple anthropometric measurements and Pcr.

Original languageEnglish (US)
Pages (from-to)16-21
Number of pages6
JournalPediatric Nephrology
Volume3
Issue number1
DOIs
StatePublished - Mar 1 1989

Keywords

  • Anthropometry
  • Creatinine
  • Glomerular filtration rate
  • Kidney function
  • Malnutrition
  • Muscle mass

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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    Brion, L. P., Boeck, M. A., Gauthier, B., Nussbaum, M. P., & Schwartz, G. J. (1989). Estimation of glomerular filtration rate in anorectic adolescents. Pediatric Nephrology, 3(1), 16-21. https://doi.org/10.1007/BF00859618