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Uemura O.,The Committee of Measures for Pediatric CKD | Uemura O.,Aichi Childrens Health And Medical Center | Nagai T.,The Committee of Measures for Pediatric CKD | Ishikura K.,The Committee of Measures for Pediatric CKD | And 7 more authors.
Clinical and Experimental Nephrology | Year: 2015

Background: The present study was performed to determine the reference values of glomerular filtration rate (GFR) in children by age using the new eGFR equations derived from serum creatinine (Cr) and cystatine C (cysC). Methods: A total of 1137 children (509 males and 628 females) between the ages of 3 months and 16 years presenting at our facilities between 2008 and 2009 without diseases affecting the renal function were included in this study as in our previous reports for reference values of serum Cr and cysC. We calculated eGFR with the Cr based equation in children aged 2–16 years, and with the cysC based equation in those aged 3–23 months, and determined the reference values of GFR in Japanese children by each age group. Results: We reviewed the median, 2.5 and 97.5 percentile of GFR reference value in each age group. The medians of reference GFRs are 91.7, 98.5, 106.3, and 113.1 mL/min/1.73 m2 in children aged 3–5, 6–11, 12–17, and 18 months–16 years, respectively. Conclusion: We determined the normal reference values of GFR in children. It is important for pediatricians who examine pediatric chronic kidney disease patients to know the values of normal renal function. © 2014, Japanese Society of Nephrology.


Ikezumi Y.,The Committee of Measures for Pediatric CKD | Ikezumi Y.,Niigata University | Uemura O.,The Committee of Measures for Pediatric CKD | Nagai T.,The Committee of Measures for Pediatric CKD | And 8 more authors.
Clinical and Experimental Nephrology | Year: 2015

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. © 2014, Japanese Society of Nephrology.


PubMed | The Committee of Measures for Pediatric CKD
Type: Journal Article | Journal: Clinical and experimental nephrology | Year: 2015

The present study was performed to determine the reference values of glomerular filtration rate (GFR) in children by age using the new eGFR equations derived from serum creatinine (Cr) and cystatine C (cysC).A total of 1137 children (509 males and 628 females) between the ages of 3 months and 16 years presenting at our facilities between 2008 and 2009 without diseases affecting the renal function were included in this study as in our previous reports for reference values of serum Cr and cysC. We calculated eGFR with the Cr based equation in children aged 2-16 years, and with the cysC based equation in those aged 3-23 months, and determined the reference values of GFR in Japanese children by each age group.We reviewed the median, 2.5 and 97.5 percentile of GFR reference value in each age group. The medians of reference GFRs are 91.7, 98.5, 106.3, and 113.1 mL/min/1.73 m(2) in children aged 3-5, 6-11, 12-17, and 18 months-16 years, respectively.We determined the normal reference values of GFR in children. It is important for pediatricians who examine pediatric chronic kidney disease patients to know the values of normal renal function.

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