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\begin{document}

\title{Consistent Methods for Fat Free Mass, Creatinine Clearance and
Glomerular Filtration Rate to describe Renal Function from Neonates to
Adults}



\author[1]{Conor O'Hanlon}%
\author[2]{Anita Sumpter}%
\author[3]{Hesham Al-Sallami}%
\author[1]{Nick Holford}%
\affil[1]{The University of Auckland}%
\affil[2]{Auckland City Hospital}%
\affil[3]{University of Otago}%


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  \date{May 08, 2024}


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\begin{abstract}
Quantifying the effect of kidney disease on glomerular filtration rate
(GFR) is important when describing variability in clearance of drugs
eliminated by the kidney. We aimed to develop a continuous model for
renal function (RF) from prematurity to adulthood based on consistent
models for fat free mass (FFM), creatinine production rate (CPR) and
GFR. A model for fractional FFM in premature neonates to adults was
developed using pooled data from 4462 subjects and 2847 FFM
observations. It was found that girls have a FFM higher than that
predicted from adult women based on height, total body mass and sex, and
boys have a FFM lower than adult men until around the onset of puberty,
when it approaches adult male values. Data from 108 subjects with
measurements of Scr and GFR were used to construct a model for CPR. CLcr
was predicted using a model for CPR (based on FFM, postmenstrual age and
sex) and serum creatinine (Scr), and avoids discontinuous predictions
between neonates, children, and adults. Individual CPR may then be used
with individual Scr to predict estimated GFR (eGFR=CPR/Scr). A
previously published model for human GFR based on 1153 GFR observations
in 923 subjects without known kidney disease was updated using the model
for fractional FFM to predict individual size and age consistent values
for the expected normal GFR (nGFR). Individual renal function was then
calculated using RF=eGFR/nGFR.%
\end{abstract}%



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