Schwartz Equation — Paediatric GFR
Estimates GFR in children and adolescents using serum creatinine and height (bedside Schwartz formula).
Score interpretation
eGFR < 15 mL/min/1.73m²: Kidney failure. CKD G5.
→ Urgent paediatric nephrology referral. Renal replacement therapy planning. Restrict fluids/electrolytes. Avoid nephrotoxins. Transplant assessment.
eGFR 15–29: Severely reduced kidney function. CKD G4.
→ Paediatric nephrology review. Renal diet (low K⁺, low phosphate). Anaemia management: EPO if indicated. Blood pressure control: ACE inhibitor.
eGFR 30–59: Moderately reduced kidney function. CKD G3.
→ Paediatric nephrology input. Monitor electrolytes, bicarbonate, phosphate, parathyroid hormone. BP monitoring. Avoid nephrotoxic medications.
eGFR 60–89: Mildly reduced kidney function. CKD G2 if structural/functional abnormality.
→ Annual monitoring. Blood pressure check. Urine protein:creatinine ratio. Investigate for underlying cause if not known.
eGFR ≥ 90: Normal or high kidney function.
→ Routine monitoring. If CKD diagnosed, continue nephrology follow-up.
Interpretation bands for the Schwartz GFR. Apply clinical judgement and local guidance.
References
- Schwartz GJ et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009.
- KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of CKD.
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Featured in these MRCEM clinical pathways
The Schwartz GFR is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.