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Clinical and Experimental Nephrology

, Volume 18, Issue 4, pp 626–633 | Cite as

Creatinine-based equation to estimate the glomerular filtration rate in Japanese children and adolescents with chronic kidney disease

  • Osamu UemuraEmail author
  • Takuhito Nagai
  • 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 evaluation of kidney function, but cannot be measured easily in children. Therefore, we utilize the serum creatinine (Cr)-based estimated GFR (eGFR) measuring serum Cr by the enzymatic method, and we have reported simple serum Cr-based eGFR in Japanese children aged between 2 and 11 years old. Furthermore, we should use serum Cr-based eGFR in Japanese adolescents as well as children with chronic kidney disease for evaluation of renal function.

Methods

The inulin clearance and serum Cr level determined by an enzymatic method were measured in 131 pediatric chronic kidney disease (CKD) patients between the ages of 2 and 18 years old with no underlying disease affecting renal function except CKD to determine the serum Cr-based eGFR in Japanese children and adolescents.

Results

We offer the complex estimated GFR equation using polynomial formulae for reference serum creatinine levels with body length in Japanese children except infants, resulting in the following equation:
$$ {\text{eGFR}} = 110.2 \times ({\text{reference serum Cr}}/{\text{patient's serum Cr}}) + 2.93 $$
Reference serum Cr levels (y) are shown by the following two equations of body length (x):
$$ \begin{aligned} {\text{Males}}:\quad \, y = & -1.259x^{5} + 7.815x^{4} -18.57x^{3} + 21.39x^{2} -11.71x + 2.628 \\ {\text{Females}}:\quad \, y = & -4.536x^{5} + 27.16x^{4} -63.47x^{3} + 72.43x^{2} -40.06x + 8.778 \\ \end{aligned} $$

Conclusion

The new polynomial eGFR formula showing the relationship with body length and serum Cr level may be applicable for clinical screening of renal function in Japanese children and adolescents aged between 2 and 18 years.

Keywords

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

Notes

Acknowledgments

This study was financially supported by the Kidney Foundation, Japan, which enabled us to examine blood and urine specimens gathered 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, 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 patients in this study.

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Copyright information

© Japanese Society of Nephrology 2013

Authors and Affiliations

  • Osamu Uemura
    • 1
    Email author
  • Takuhito Nagai
    • 1
  • Kenji Ishikura
    • 2
  • Shuichi Ito
    • 3
  • Hiroshi Hataya
    • 2
  • Yoshimitsu Gotoh
    • 4
  • Naoya Fujita
    • 5
  • Yuko Akioka
    • 6
  • Tetsuji Kaneko
    • 7
  • Masataka Honda
    • 2
  1. 1.Department of Pediatric NephrologyAichi Children’s Health and Medical CenterObuJapan
  2. 2.Department of NephrologyTokyo Metropolitan Children’s Medical CenterTokyoJapan
  3. 3.Department of NephrologyNational Center for Child Health and DevelopmentTokyoJapan
  4. 4.Department of Pediatric NephrologyNagoya Daini Red Cross HospitalNagoyaJapan
  5. 5.Department of PediatricsSeirei Hamamatsu General HospitalHamamatsu, ShizuokaJapan
  6. 6.Department of Pediatric NephrologyTokyo Women’s Medical UniversityTokyoJapan
  7. 7.Department of Clinical ResearchTokyo Metropolitan Children’s Medical CenterTokyoJapan

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