{
  "abstract": "Background: Accurate estimation of glomerular filtration rate (GFR) is essential when dosing many medications. Existing paediatric GFR equations vary in accuracy, with only one (Modified Schwartz) validated in children <2 years. This study developed a new paediatric GFR equation (GROW-GFR) using a tobramycin population pharmacokinetic model and evaluated its performance against current equations and nuclear medicine (NM)-GFR scans.\n\nMethods: Retrospective analysis of NM-GFR scans from July 2016-November 2023 in children aged 0–19 years at The Royal Children’s Hospital, Melbourne. Results were included if NM-GFR was ≤150 mL/min and height, weight and serum creatinine were recorded. Accuracy of GFR estimates within 30% and 10% of NM-GFR results (p30, p10 accuracy) and bias for the GROW-GFR, Modified Schwartz, Chronic Kidney Disease in Children Under 25 years (CKiD-U25), Full Age Spectrum (FAS), and FAS-height (HT) equations were assessed.\n\nResults: Overall, 1560 NM-GFR results from 711 children (median age 8.5 years; range 0.1–19) were included (median NM-GFR 55 mL/min; range 0.5–150). GROW-GFR showed a p30 accuracy of 76% and bias of −1.9 mL/min, with consistent performance across all ages. The Modified Schwartz equation had a p30 accuracy of 46% and bias of 17.3 mL/min. In children ≥2 years, GROW-GFR outperformed other equations (p30: 76% vs. 49%–58%; bias −1.9 vs. 13.7–18.4 mL/min). After applying linear mixed-effects models, GROW-GFR p30 accuracy and bias were 80% and −2.5 mL/min, outperforming other equations (p < 0.001).\n\nConclusion: The GROW-GFR equation provided more accurate GFR estimates across all paediatric ages, including children <2 years, compared to existing equations. Therefore, should be considered the preferred GFR estimation method.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Paediatrics, The University of Melbourne",
    "Antimicrobials Group, Murdoch Children’s Research Institute",
    "Certara",
    "School of Mathematics and Statistics, The University of Melbourne",
    "Kidney Regeneration, Murdoch Research Institute",
    "Department of Paediatric Nephrology, The Royal Children’s Hospital",
    "Department of Medical Imaging, The Royal Children’s Hospital Melbourne",
    "Department of Pharmacy, The Children’s Hospital at Westmead",
    "Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney",
    "Department of Respiratory and Sleep Medicine, The Royal Children’s Hospital",
    "Respiratory Diseases Group, Murdoch Children’s Research Institute",
    "Department of General Medicine and Infectious Diseases, Royal Children’s Hospital"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Kiera H. Harwood"
    },
    {
      "affs": [
        2
      ],
      "name": "Stephen Duffull"
    },
    {
      "affs": [
        3
      ],
      "name": "Christian Davey"
    },
    {
      "affs": [
        0,
        4,
        5
      ],
      "name": "Catherine Quinlan"
    },
    {
      "affs": [
        0,
        4,
        5
      ],
      "name": "Thomas Forbes"
    },
    {
      "affs": [
        6
      ],
      "name": "Peter Francis"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Tony Lai"
    },
    {
      "affs": [
        0,
        9,
        10
      ],
      "name": "Sarath Ranganathan"
    },
    {
      "affs": [
        0,
        1,
        11
      ],
      "name": "Amanda Gwee"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6j94gyweky056.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1855031",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736570/",
  "id": "6j94gyweky056",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1855031/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2727|Chronic Kidney Disease and Diabetes"
    ]
  ],
  "openalex": "W7223181691",
  "pdf_url": "https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1855031/pdf",
  "pmcid": "PMC13736570",
  "pmid": "42991721",
  "published": "2026-10-22",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/6j94gyweky056.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1855031",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1855031/full"
    },
    {
      "first_seen": "2026-11-09T12:21:59Z",
      "native_id": "PMC13736570",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fphar.2026.1855031"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1663-9812",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Refining absolute GFR estimation in children: development and validation of the GROW-GFR equation",
  "title_text": "Refining absolute GFR estimation in children: development and validation of the GROW-GFR equation",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:21:59Z",
  "url": "https://research.draconitic.com/paper/6j94gyweky056",
  "venue": "Frontiers in Pharmacology",
  "versions": []
}