Glomerular filtration rate estimation formulas for pediatric and neonatal use

Abstract

Renal function assessment is of the utmost importance in predicting drug clearance and in ensuring safe and effective drug therapy in neonates. The challenges to making this prediction relate not only to the extreme vulnerability and rapid maturation of this pediatric subgroup but also to the choice of renal biomarker, covariates, and glomerular filtration rate (GFR) estimating formula. In order to avoid burdensome administration of exogenous markers and/or urine collection in vulnerable pediatric patients, estimation of GFR utilizing endogenous markers has become a useful tool in clinical practice. Several estimation methods have been developed over recent decades, exploiting various endogenous biomarkers (serum creatinine, cystatin C, blood urea nitrogen) and anthropometric measures (body length/height, weight, muscle mass). This article reviews pediatric GFR estimation methods with a focus on their suitability for use in the neonatal population.