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Cystatin C-based equation for estimating glomerular filtration rate in Japanese children and adolescents

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Abstract

Background

Renal inulin clearance is the gold standard for evaluation of kidney function, but is compromised by problems of collecting urine samples in children, especially those <6 years or with a bladder dysfunction. Therefore, we should utilize the serum cystatin C (cysC)-based estimated glomerular filtration rate (eGFR) for measuring serum cysC. The purpose of the present study is to determine the applicability of the new serum cysC-based eGFR in Japanese children and adolescents, including infants with chronic kidney disease (CKD), for evaluation of renal function.

Methods

Inulin clearance and standardized serum cysC level determined by the colloidal gold immunoassay were measured in 135 pediatric CKD patients between the ages of 1 month and 18 years with no underlying disease that affects renal function except CKD, to determine serum cysC-based eGFR in Japanese children and adolescents.

Results

We showed the inulin clearance by expression of 1/serum cysC in pediatric CKD patients, which resulted in the equation: inulin GFR (mL/min/1.73 m2) = 104.1 × 1/serum cysC (mg/L) − 7.80. We also validated the cysC-based eGFR formula for Japanese adults. eGFR values obtained with the adult formula significantly underestimated GFR by approximately 8 % in children with CKD.

Conclusion

We determined the new cysC-based eGFR formula is useful for clinical screening of renal function in Japanese children and adolescents, including infants.

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Acknowledgments

Financial supported by the Kidney Foundation, Japan enabled us to examine blood or urine specimens collected throughout Japan. We thank Takeshi Matsuyama, MD, Yohei Ikezumi, MD, Midori Awazu, MD, Takashi Sekine, MD, Mayumi Sako, MD, Takuji Yamada, MD, Yuko Akioka, MD, Hirotsugu Kitayama, MD, Mayumi Sako, MD, Masataka Hisano, MD and Kazumoto Iijima, MD of the Committee of Measures for Pediatric CKD, for their contributions to the improvement of this manuscript, and Kenichi Satomura, MD and Yuhei Ito, MD for their contributions to the participation of cases in this study.

Conflict of interest

The authors declare there are no conflicts of interest.

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Authors and Affiliations

  1. The Japanese Society for Pediatric Nephrology, the Committee of Measures for Pediatric CKD, Tokyo, Japan

    Osamu Uemura, Takuhito Nagai, Kenji Ishikura, Shuichi Ito, Hiroshi Hataya, Yoshimitsu Gotoh, Naoya Fujita, Yuko Akioka, Tetsuji Kaneko & Masataka Honda

  2. Department of Pediatric Nephrology, Aichi Children’s Health and Medical Center, 1-2 Osakada Morioka-cho, Obu, Aichi, 474-8710, Japan

    Osamu Uemura

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  1. Osamu Uemura
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  2. Takuhito Nagai
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  3. Kenji Ishikura
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  4. Shuichi Ito
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  5. Hiroshi Hataya
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  6. Yoshimitsu Gotoh
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  7. Naoya Fujita
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  8. Yuko Akioka
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  9. Tetsuji Kaneko
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  10. Masataka Honda
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Correspondence to Osamu Uemura.

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Uemura, O., Nagai, T., Ishikura, K. et al. Cystatin C-based equation for estimating glomerular filtration rate in Japanese children and adolescents. Clin Exp Nephrol 18, 718–725 (2014). https://doi.org/10.1007/s10157-013-0910-9

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  • DOI: https://doi.org/10.1007/s10157-013-0910-9

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