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Clinical and Experimental Nephrology

, Volume 17, Issue 6, pp 877–881 | Cite as

Creatinine-based equations to estimate glomerular filtration rate in Japanese children aged between 2 and 11 years old with chronic kidney disease

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

Abstract

Background

Renal inulin clearance is the gold standard for glomerular filtration rate (GFR), but is compromised by problems of collecting urine samples in children, especially those <6 years of age or with a bladder dysfunction. Therefore, we should utilize the serum creatinine (Cr)-based estimated GFR (eGFR), measuring serum Cr by enzymatic method. The updated Schwartz formulae were reported by enzymatic Cr instead of by the Jaffe method in American children aged 1–16 years old. We believe it would be better to determine serum Cr-based eGFR by the enzymatic method in Japanese children for evaluation of renal function.

Methods

Serum Cr-based eGFR was determined by measuring inulin clearance and serum Cr level in 76 pediatric chronic kidney disease (CKD) patients (49 males and 27 females) aged 2–11 years with no underlying disease that would affect renal function.

Results

We showed the inulin clearance by expression of the body length/serum Cr ratio in pediatric CKD patients, which resulted in the equation: \( {\text{inulin}}\;{\text{GFR}} = 0. 3 4 2 \times {\text{body length}}\;({\text{cm}})/{\text{serum}}\;{\text{Cr}}\;({\text{mg}}/{\text{dL}}) \pm 2. 7 5 \). Additionally, we suggest the following serum Cr-based eGFR formula passing through the origin: \( {\text{eGFR}}\; ( {\text{mL}}/{ \hbox{min} }/ 1. 7 3 \,{\text{m}}^{ 2} )= 0. 3 5 \times {\text{body}}\;{\text{length}}\; ( {\text{cm)/serum}}\;{\text{Cr}}\; ( {\text{mg}}/{\text{dL)}} \), because it is simple and easy to remember, thus making it clinically useful.

Conclusion

The new eGFR formula derived from body length and serum Cr level is applicable for clinical screening of renal function in Asian as well as Japanese children aged between 2 and 11 years old.

Keywords

Estimate glomerular filtration rate Japanese children Creatinine-based equation Chronic kidney disease 

Notes

Acknowledgments

This study was financially supported by the Kidney Foundation, Japan, and this support helped us to examine the blood or urine specimens gathered from all over 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. The authors have declared that no conflict of interest exists.

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Copyright information

© Japanese Society of Nephrology 2013

Authors and Affiliations

  • Takuhito Nagai
    • 1
  • Osamu Uemura
    • 1
    • 2
  • Kenji Ishikura
    • 1
  • Shuichi Ito
    • 1
  • Hiroshi Hataya
    • 1
  • Yoshimitsu Gotoh
    • 1
  • Naoya Fujita
    • 1
  • Yuko Akioka
    • 1
  • Tetsuji Kaneko
    • 1
  • Masataka Honda
    • 1
  1. 1.The Japanese Society for Pediatric Nephrology, the Committee of Measures for Pediatric CKDTokyoJapan
  2. 2.Department of Pediatric NephrologyAichi Children’s Health and Medical CenterObuJapan

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