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Uemura O.,The Japanese Society for Pediatric Nephrology | Uemura O.,Aichi Childrens Health and Medical Center | Honda M.,The Japanese Society for Pediatric Nephrology | Matsuyama T.,The Japanese Society for Pediatric Nephrology | And 9 more authors.
Clinical and Experimental Nephrology | Year: 2011

Background: Enzymatic methods have recently been used to measure creatinine (Cr) instead of the Jaffe method. Therefore, it is necessary to determine the reference serum Cr value for these enzymatic methods to evaluate renal function in Japanese children. Methods: To determine reference values of serum Cr in Japanese children, 1151 children (517 male, 634 female) aged between 1 month and 18 years had their serum Cr values measured by an enzymatic method. To be included in the study the children had to be without kidney disease, urogenital disease, infectious disease, inflammatory disease, dehydration, muscular disease, anomaly syndrome, cardiovascular disease, malignant disease, hypertension, liver or pancreas disease, or pregnancy. Results: The medians of reference values increased gradually with age, i.e., 0.30 mg/dl at 4 years old and 0.41 mg/dl at 10 years old. In adolescence, they increased significantly more rapidly in males than in females. We found a linear regression equation capable of estimating the reference value of serum Cr in children aged 2-11 years, and quintic regression equations capable of estimating the reference values of serum Cr in male and female children of all ages. Conclusion: The reference serum Cr levels determined by an enzymatic method related to age, gender, and body length, and our linear and polynomial equations showing the relationship between body length and serum Cr level will be applicable for screening of renal function in Asian as well as Japanese children. © 2011 Japanese Society of Nephrology.


Uemura O.,The Japanese Society for Pediatric Nephrology | Uemura O.,Aichi Childrens Health and Medical Center | Nagai T.,The Japanese Society for Pediatric Nephrology | Ishikura K.,The Japanese Society for Pediatric Nephrology | And 7 more authors.
Clinical and Experimental Nephrology | Year: 2014

Background: Renal inulin clearance is the gold standard for evaluation of kidney function, but is compromised by problems of collecting urine samples in children, especially those <6 years or with a bladder dysfunction. Therefore, we should utilize the serum cystatin C (cysC)-based estimated glomerular filtration rate (eGFR) for measuring serum cysC. The purpose of the present study is to determine the applicability of the new serum cysC-based eGFR in Japanese children and adolescents, including infants with chronic kidney disease (CKD), for evaluation of renal function.Methods: Inulin clearance and standardized serum cysC level determined by the colloidal gold immunoassay were measured in 135 pediatric CKD patients between the ages of 1 month and 18 years with no underlying disease that affects renal function except CKD, to determine serum cysC-based eGFR in Japanese children and adolescents.Results: We showed the inulin clearance by expression of 1/serum cysC in pediatric CKD patients, which resulted in the equation: inulin GFR (mL/min/1.73 m2) = 104.1 × 1/serum cysC (mg/L) − 7.80. We also validated the cysC-based eGFR formula for Japanese adults. eGFR values obtained with the adult formula significantly underestimated GFR by approximately 8 % in children with CKD.Conclusion: We determined the new cysC-based eGFR formula is useful for clinical screening of renal function in Japanese children and adolescents, including infants. © 2013, Japanese Society of Nephrology.

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