@Article{chd.12776,
AUTHOR = {Danielle Kirelik, Mark Fisher, Michael DiMaria, Danielle E. Soranno, Katja M. Gist},
TITLE = {Comparison of creatinine and cystatin C for estimation of glomerular filtration rate in pediatric patients after Fontan operation},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {5},
PAGES = {760--764},
URL = {http://www.techscience.com/schd/v14n5/38837},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> There are several limitations when using creatinine to estimate glomerular filtration rate, especially in children with chronic medical conditions who are at 
high risk of kidney dysfunction. Cystatin C has been the recent focus of research as a 
replacement biomarker for creatinine. Our objective was to compare the 2 biomarkers in pediatric single‐ventricle heart disease patients who have undergone the 
Fontan operation. We hypothesized that there would be poor correlation and agreement between the 2 estimates of renal function.<br/>
<b>Methods:</b> This was a single center retrospective chart review of 20 patients who had 
previously undergone Fontan operation. Demographic and clinical data were collected from medical records. Blood samples were collected as part of routine clinical 
care and simultaneously measured for serum creatinine and cystatin C. Glomerular 
filtration rate was calculated using the creatinine‐based bedside Schwartz formula 
and cystatin C‐based Zapatelli equation. Spearman correlation and Bland‐Altman 
analysis were used to assess correlation and agreement.<br/>
<b>Results:</b> The median Schwartz‐derived estimated glomerular filtration rate was 98.94 
mL/min/1.73 m<sup>2</sup>
 while the median Zappitelli‐derived estimated glomerular filtration 
rate was 84.76 mL/min/1.73 m<sup>2</sup>
. The mean difference was −19.27 suggesting poor 
agreement. There was weak to moderate correlation between the Schwartz and cystatin C estimated glomerular filtration rate.<br/>
<b>Conclusion:</b> The bedside Schwartz formula may be an overestimate of glomerular filtration rate in pediatric single‐ventricle heart disease patients who have undergone the 
Fontan operation. While larger studies are necessary, cystatin C is a promising biomarker to replace creatinine and better estimate kidney function in this population.},
DOI = {10.1111/chd.12776}
}