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Beta-2 microglobulin-based equation for estimating glomerular filtration rates in Japanese children and adolescents

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Abstract

Background

Although the creatinine (Cr)-based equation is widely used for estimating glomerular filtration rate (GFR), this equation is not ideally suited for children with low body weight or aged <2 years. Therefore, we established a new equation using serum beta-2 microglobulin (β2MG) levels for Japanese children with chronic kidney disease (CKD).

Methods

Inulin clearance and standardized serum β2MG and Cr levels were measured in 137 CKD patients aged 1 month–18 years. Using the previously established normal β2MG levels, Cr reference values, and Cr-based equation of estimated GFR (eGFR) in Japanese children, receiver operating characteristics (ROC) analyses were performed to compare the diagnostic accuracy between β2MG- and Cr-based estimations of GFR.

Results

Serum β2MG concentrations progressively increased as GFRs reduced. The correlation coefficients between GFR and β2MG, and between GFR and 1/β2MG were −0.74 (p < 0.001) and 0.86 (p < 0.001), respectively. The inulin clearance, as based on 1/serum β2MG expression, in pediatric CKD patients resulted in the equation: inulin GFR (mL/min/1.73 m2) = 149.0 × 1/serum β2MG (mg/L) +9.15. ROC analyses indicated that the ability of serum β2MG-based GFR <95 mL/min/1.73 m2 in children >2 years was better than the Cr-based estimated GFR (areas under the ROC curve 0.960 vs. 0.948, respectively).

Conclusion

The new β2MG-based eGFR formula is useful for clinical screening of renal function in Japanese children and adolescents, and measurement of serum β2MG and Cr levels as markers for predicting glomerular function may aid the early detection of mildly reduced GFR in this population.

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Acknowledgments

Financial support by the Kidney Foundation, Japan enabled us to examine blood or urine specimens collected throughout Japan. We thank Takeshi Matsuyama, MD, Midori Awazu, MD, Takashi Sekine, MD, Mayumi Sako, MD, Takuji Yamada, MD, Yuko Akioka, MD, Hirotsugu Kitayama, MD, Mayumi Sako, MD, and Masataka Hisano, 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 enrollment of cases in this study.

Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

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

    Yohei Ikezumi, Osamu Uemura, Takuhito Nagai, Kenji Ishikura, Shuichi Ito, Hiroshi Hataya, Naoya Fujita, Yuko Akioka, Tetsuji Kaneko, Kazumoto Iijima & Masataka Honda

  2. Department of Pediatrics, Niigata University Medical and Dental Hospital, Asahimachi-dori, Niigata, 951-8510, Japan

    Yohei Ikezumi

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  1. Yohei Ikezumi
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Correspondence to Yohei Ikezumi.

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Ikezumi, Y., Uemura, O., Nagai, T. et al. Beta-2 microglobulin-based equation for estimating glomerular filtration rates in Japanese children and adolescents. Clin Exp Nephrol 19, 450–457 (2015). https://doi.org/10.1007/s10157-014-1015-9

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  • DOI: https://doi.org/10.1007/s10157-014-1015-9

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