Background <p>Glomerular filtration rate (GFR) is a critical indicator of kidney function in kidney diseases. However, well-recognized estimated GFR (eGFR) equations for pediatric populations in specific cohorts remain elusive. This study aimed to evaluate and compare the performance of various eGFR equations against measured GFR (mGFR).</p> Methods <p>A total of 221 children were included. Fourteen eGFR equations were compared with mGFR using Spearman’s correlation analysis, Bland-Altman analysis, and by assessing bias, precision, and accuracy. Subgroup analyses were conducted to further evaluate the performance of eGFR equations.</p> Results <p>The mGFR value showed no statistical difference from the eGFR values obtained using the CKiD (combined-creatinine (Cr)/cystatin C (CysC)/blood urea nitrogen (BUN)) and Tang (combined-Cr/CysC/BUN) equations (<i>P</i> = 0.265 and 0.653, respectively). The CKiD (combined-Cr/CysC/BUN) and Tang (combined-Cr/CysC/BUN) equations demonstrated the highest correlation (r = 0.509 and 0.455, respectively) and agreement (mean difference = −1.4 and 2.2, respectively), with the lowest bias (bias = 0.1 and 2.7, respectively) and the highest precision (median absolute value = 27.3 and 26.2, respectively) and accuracy (P₃₀ accuracies = 83.3% and 80.5%, respectively). Latent profile analysis grouped these two equations with mGFR in the same cluster. Subgroup analyses further confirmed the superior performance of these equations.</p> Conclusion <p>The eGFR equations incorporating Cr, BUN, and CysC simultaneously demonstrated higher accuracy and precision. The CKiD (combined-Cr/CysC/BUN) and Tang (combined-Cr/CysC/BUN) equations exhibited the highest correlation and agreement with mGFR, suggesting their potential as alternatives when mGFR is unavailable in Chinese pediatric populations.</p> Impact <p><UnorderedList Mark="Bullet"> <ItemContent> <p>Glomerular filtration rate (GFR) serves as a crucial indicator of kidney function. In clinical settings, accurate assessment of GFR is vital for ensuring timely therapeutic interventions and enhancing patient outcomes.</p> </ItemContent> <ItemContent> <p>The eGFR equations that simultaneously incorporate creatinine (Cr), cystatin C (CysC), and blood urea nitrogen (BUN) exhibit enhanced accuracy and precision.</p> </ItemContent> <ItemContent> <p>The CKiD (combined-Cr/CysC/BUN) and Tang (combined-Cr/CysC/BUN) equations demonstrated the strongest correlation and agreement with mGFR. This indicates that they may serve as viable alternatives when mGFR is not available in pediatric populations.</p> </ItemContent> </UnorderedList></p>