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Clinical and Experimental Nephrology

, Volume 22, Issue 4, pp 931–937 | Cite as

Validation of estimated glomerular filtration rate equations for Japanese children

  • Yoshimitsu Gotoh
  • Osamu Uemura
  • Kenji Ishikura
  • Tomoyuki Sakai
  • Yuko Hamasaki
  • Yoshinori Araki
  • Riku Hamda
  • Masataka Honda
  • On behalf of the Pediatric CKD Study Group in Japan in conjunction with the Committee of Measures for Pediatric CKD of the Japanese Society of Pediatric Nephrology
Original article
  • 143 Downloads

Abstract

Background

The gold standard for evaluation of kidney function is renal inulin clearance (Cin). However, the methodology for Cin is complicated and difficult, especially for younger children and/or patients with bladder dysfunction. Therefore, we developed a simple and easier method for obtaining the estimated glomerular filtration rate (eGFR) using equations and values for several biomarkers, i.e., serum creatinine (Cr), serum cystatin C (cystC), serum beta-2 microglobulin (β2MG), and creatinine clearance (Ccr). The purpose of the present study was to validate these equations with a new data set.

Methods

To validate each equation, we used data of 140 patients with CKD with clinical need for Cin, using the measured GFR (mGFR). We compared the results for each eGFR equation with the mGFR using mean error (ME), root mean square error (RMSE), P30, and Bland–Altman analysis.

Results

The ME of Cr, cystC, β2MG, and Ccr based on eGFR was 15.8 ± 13.0, 17.2 ± 16.5, 15.4 ± 14.3, and 10.6 ± 13.0 ml/min/1.73 m2, respectively. The RMSE was 29.5, 23.8, 20.9, and 16.7, respectively. The P30 was 79.4, 71.1, 69.5, and 92.9%, respectively. The Bland–Altman bias analysis showed values of 4.0 ± 18.6, 5.3 ± 16.8, 12.7 ± 17.0, and 2.5 ± 17.2 ml/min/1.73 m2, respectively, for these parameters.

Conclusion

The bias of each eGFR equation was not large. Therefore, each eGFR equation could be used.

Keywords

Validation Equation of estimated glomerular filtration rate Children Japanese 

Notes

Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.

Human and animal rights

All procedures involving human participants were in accordance with ethical standards of the institution at which the studies were conducted (Approval Number in Japanese Red Cross Nagoya Daini Hospital 1065), and with standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was not obtained, because of use of retrospective data for clinical use. This information is noted on the website (opt-out).

References

  1. 1.
    Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am. 1987;34:571–90.CrossRefPubMedGoogle Scholar
  2. 2.
    Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20:629–37.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Uemura O, Honda M, Matsuyama T, Ishikura K, Hataya H, Nagai T, Ikezumi Y, Fujita N, Ito S, Iiijima K. Is the new Schwartz equation derived from serum creatinine and body length suitable for evaluation of renal function in Japanese children? Eur J Pediatr. 2012;171:1401–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Hona M. Creatinine-based equation to estimate the glomerular filtration rate in Japanese children and adolescents with chronic kidney disease. Clin Exp Nephrol. 2014;18:626–33.CrossRefPubMedGoogle Scholar
  5. 5.
    Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Hona M. Cystatin C-based equation for estimating glomerular filtration rate in Japanese children and adolescents. Clin Exp Nephrol. 2014;18:718–25.CrossRefPubMedGoogle Scholar
  6. 6.
    Ikezumi Y, Uemua O, Nagai T, Ishikura K, Ito S, Hataya H, Fujita N, Akioka Y, Kaneko T, Iijima K, Hona M. Beta-2 microglobulin-based equation for estimating glomerular filtration rates in Japanese children and adolescents. Clin Exp Nephrol. 2015;19:450–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Uemura O, Nagai T, Satoshi Y, Kaneko T, Hibi Y, Yamasaki Y, Yamamoto M, Nakano M. Assessment of kidney function in children by enzymatic determination of 2- or 24-h creatinine clearance: comparison with inulin clearance. Clin Exp Nephrol. 2016;20:462–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Nagai T, Uemura O, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Hona M. Creatinine-based equations to estimate glomerular filtration rate in Japanese children aged between 2 and 11 years old with chronic kidney disease. Clin Exp Nephrol. 2013;17:877–81.CrossRefPubMedGoogle Scholar
  9. 9.
    Uemura O, Honda M, Matsuyama T, Ishikura K, Hataya H, Yata N, Nagai T, Ikezumi Y, Fujita N, Ito S, Iijima K, Kitagawa T. Age, gender, and body length effects on reference serum creatinine levels determined by an enzymatic method in Japanese children: a multicenter study. Clin Exp Nephrol. 2011;15:694–9.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society of Nephrology 2018

Authors and Affiliations

  • Yoshimitsu Gotoh
    • 1
  • Osamu Uemura
    • 2
  • Kenji Ishikura
    • 3
  • Tomoyuki Sakai
    • 4
  • Yuko Hamasaki
    • 5
  • Yoshinori Araki
    • 6
  • Riku Hamda
    • 7
  • Masataka Honda
    • 7
  • On behalf of the Pediatric CKD Study Group in Japan in conjunction with the Committee of Measures for Pediatric CKD of the Japanese Society of Pediatric Nephrology
  1. 1.Department of Pediatric NephrologyJapanese Red Cross Nagoya Daini HospitalNagoyaJapan
  2. 2.Department of Clinical MedicineJapanese Red Cross Toyota College of NursingToyotaJapan
  3. 3.Department of Nephrology and RheumatologyNational Center for Child Health and DevelopmentTokyoJapan
  4. 4.Department of PediatricsShiga University of Medical ScienceOotsuJapan
  5. 5.Department of Pediatric NephrologyToho University Faculty of MedicineOotsuJapan
  6. 6.Department of PediatricsHokkaido Medical CenterSapporoJapan
  7. 7.Department of NephrologyTokyo Metropolitan Children’s Medical CenterTokyoJapan

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