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• W4381192541 abstract "<h3>Objectives</h3> Diabetic kidney disease (DKD) remains a major determinant of morbidity and mortality for people with type 1 diabetes (T1D), being the leading cause of end stage renal disease (ESRD) and a risk factor for cardiovascular disease. In youth with T1D, assessing glomerular filtration rate (GFR) is important to identify early subclinical manifestations of DKD. While various GFR equations have been assessed in the general paediatric population, none of them have been validated for youth with T1D. The aim of this study was to evaluate the performance of traditional and newly developed GFR equations in a cohort of children and adolescents with T1D. <h3>Methods</h3> We compared measured GFR (mGFR) using plasma clearance of Inutest with estimated GFR (eGFR) in a subgroup of youth with T1D recruited in the Oxford Regional Prospective Study. eGFR was calculated using 9 equations: Full-age spectrum (FAS)-height, FAS-age, Lund-Malmo (LM)-revised, Chronic Kidney Disease Epidemiology (CKD-EPI, CKD-EPI1, CKID-EPI40), CKD Disease in Children equations (CKID, CKID1, CKID2). We performed Bland-Altman analyses and estimated performance (i.e. bias and accuracy [P30]) for each eGFR formula for the whole study population and specific subgroups, based on age and sex. <h3>Results</h3> The study population included 141 children and adolescents (79 males), who underwent a direct GFR assessment (mGFR) at a mean age of 13.5±3.3 years (range 6.2–18.4 years) and diabetes duration of 5.7±1.6 years. Mean serum creatinine was 45.6±12.1 umol/L and mGFR was 142.3±25.0 ml/min/m2. No study participants had a mGFR< 90 ml/min/m2 and 72.34 % had a GFR in the hyperfiltration range (>125 ml/min/m2). For the whole population, the equation with the best performance was CKID2 (bias= 0.84 ml/min/m2; P30= 87.2%). In subgroup analyses, CKD-Epi40 showed the lowest bias in females (bias=0.79 ml/min/m2; P30 = 0.32%) and LMrev in males (bias=1.75 ml/min/m2; P30= 75.9%). In youth <11 years-old and 11–15.9 years-old, CKID showed the best performance (bias=7.78 ml/min/m2; P30= 78.4%, and bias=4.10 ml/min/m2; P30= 83.6%, respectively), whereas in the 16–18.4 years-old group, it was CKD-Epi (bias=-1.53 ml/min/m2; P30= 84.6%). <h3>Conclusion</h3> Our preliminary results indicate that different subgroups of youth with T1D may benefit from using different formulas to calculate eGFR for a more accurate assessment of renal function. Future studies are needed to develop a better eGFR formula which could be reliably used in clinical practice. <h3>References</h3> Bogdanović R. Diabetic nephropathy in children and adolescents. <i>Pediatric Nephrology</i> (Berlin, Germany), 2008;<b>23</b>(4):507–525. https://doi.org/10.1007/s00467-007-0583-2 Marcovecchio ML, Dalton RN, Turner C, Prevost AT, Widmer B, Amin R, Dunger DB. Symmetric dimethylarginine, an endogenous marker of glomerular filtration rate, and the risk for microalbuminuria in young people with type 1 diabetes. <i>Archives of Disease in Childhood</i> 2010;<b>95</b>(2):119–124. https://doi.org/10.1136/adc.2009.158394 Boettcher C, Utsch B, Galler A, Grasemann C, Borkenstein MH, Denzer C, Heidtmann B, Tittel SR, Holl RW. Estimated Glomerular Filtration Rates Calculated by New and Old Equations in Children and Adolescents With Type 1 Diabetes—What to Do With the Results? <i>Frontiers in Endocrinology</i> 2020;11. Gaebe K, White CA, Mahmud FH, Scholey JW, Elia YT, Sochett EB, Cherney DZ. Evaluation of novel glomerular filtration rate estimation equations in adolescents and young adults with type 1 diabetes. <i>Journal of Diabetes and its Complications</i> 2022;<b>36</b>(1):108081. https://doi.org/10.1016/j.jdiacomp.2021.108081" @default.
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• W4381192541 date "2023-06-19" @default.
• W4381192541 modified "2023-09-26" @default.
• W4381192541 title "432 Which glomerular filtration rate equation should be used in youth with Type 1 diabetes?" @default.
• W4381192541 doi "https://doi.org/10.1136/archdischild-2023-rcpch.398" @default.
• W4381192541 hasPublicationYear "2023" @default.
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