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Erschienen in: Clinical and Experimental Nephrology 5/2014

01.10.2014 | Original Article

Cystatin C-based equation for estimating glomerular filtration rate in Japanese children and adolescents

verfasst von: Osamu Uemura, Takuhito Nagai, Kenji Ishikura, Shuichi Ito, Hiroshi Hataya, Yoshimitsu Gotoh, Naoya Fujita, Yuko Akioka, Tetsuji Kaneko, Masataka Honda

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 5/2014

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Abstract

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.
Literatur
1.
Zurück zum Zitat Grubb A, Lofberg H. Human γ-trace. Structure, function and clinical use of concentration measurements. Scand J Clin Lab Invest. 1985;45:7–13. Grubb A, Lofberg H. Human γ-trace. Structure, function and clinical use of concentration measurements. Scand J Clin Lab Invest. 1985;45:7–13.
2.
Zurück zum Zitat Olafsson I. The human cystatin C gene promoter: functional analysis and identification of heterogeneous mRNA. Scand J Clin Lab Invest. 1995;55:597–607.PubMedCrossRef Olafsson I. The human cystatin C gene promoter: functional analysis and identification of heterogeneous mRNA. Scand J Clin Lab Invest. 1995;55:597–607.PubMedCrossRef
3.
Zurück zum Zitat Nagai T, Uemura O, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Honda 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 (Epub ahead of print). Nagai T, Uemura O, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Honda 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 (Epub ahead of print).
4.
Zurück zum Zitat Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Honda M. Creatinine-based equations to estimate glomerular filtration rate in Japanese children and adolescents with chronic kidney disease. Clin Exp Nephrol. 2013 (Epub ahead of print). Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Honda M. Creatinine-based equations to estimate glomerular filtration rate in Japanese children and adolescents with chronic kidney disease. Clin Exp Nephrol. 2013 (Epub ahead of print).
5.
Zurück zum Zitat Brodehl J, Gellissen K. Endogenous renal transport of free amino acids in infancy and childhood. Pediatrics. 1968;42:395–404.PubMed Brodehl J, Gellissen K. Endogenous renal transport of free amino acids in infancy and childhood. Pediatrics. 1968;42:395–404.PubMed
6.
Zurück zum Zitat Cole BR, Giangiacomo J, Ingelfinger JR, Robson AM. Measurement of renal function without urine collection. A critical evaluation of the constant-infusion technic for determination of inulin and para-aminohippurate. N Engl J Med. 1972;287:1109–14.PubMedCrossRef Cole BR, Giangiacomo J, Ingelfinger JR, Robson AM. Measurement of renal function without urine collection. A critical evaluation of the constant-infusion technic for determination of inulin and para-aminohippurate. N Engl J Med. 1972;287:1109–14.PubMedCrossRef
7.
Zurück zum Zitat 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.PubMed 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.PubMed
8.
Zurück zum Zitat Schwartz GJ, Feld LG, Langford DJ. A simple estimate of glomerular filtration rate in full-term infants during the first year of life. J Pediatr. 1984;104:849–54.PubMedCrossRef Schwartz GJ, Feld LG, Langford DJ. A simple estimate of glomerular filtration rate in full-term infants during the first year of life. J Pediatr. 1984;104:849–54.PubMedCrossRef
9.
Zurück zum Zitat Schwartz GJ, Gauthier B. A simple estimate of glomerular filtration rate in adolescent boys. J Pediatr. 1985;106:522–6.PubMedCrossRef Schwartz GJ, Gauthier B. A simple estimate of glomerular filtration rate in adolescent boys. J Pediatr. 1985;106:522–6.PubMedCrossRef
10.
Zurück zum Zitat Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics. 1976;58:259–63.PubMed Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A. A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics. 1976;58:259–63.PubMed
11.
Zurück zum Zitat Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr. 1978;93:62–6.PubMedCrossRef Haycock GB, Schwartz GJ, Wisotsky DH. Geometric method for measuring body surface area: a height-weight formula validated in infants, children, and adults. J Pediatr. 1978;93:62–6.PubMedCrossRef
12.
Zurück zum Zitat Itho Y, Hosogaya S, Ichihara K, et al. Standardization of serum cystatin C immunoassay using calibrator of each assay system, in which assigned values are transferred from ERM-DA 471/IFCC. Rinshokagaku. 2012;41:62–71. Itho Y, Hosogaya S, Ichihara K, et al. Standardization of serum cystatin C immunoassay using calibrator of each assay system, in which assigned values are transferred from ERM-DA 471/IFCC. Rinshokagaku. 2012;41:62–71.
13.
Zurück zum Zitat Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S, Collaborators Developing the Japanese Equation for Estimated GFR. GFR estimation using standardized serum cystatin C in Japan. Am J Kidney Dis. 2013;61:197–203.PubMedCrossRef Horio M, Imai E, Yasuda Y, Watanabe T, Matsuo S, Collaborators Developing the Japanese Equation for Estimated GFR. GFR estimation using standardized serum cystatin C in Japan. Am J Kidney Dis. 2013;61:197–203.PubMedCrossRef
14.
Zurück zum Zitat Bökenkamp A, Domanetzki M, Zinck R, Schumann G, Byrd D, Brodehl J. Cystatin C serum concentrations underestimate glomerular filtration rate in renal transplant recipients. Clin Chem. 1999;45:1866–8.PubMed Bökenkamp A, Domanetzki M, Zinck R, Schumann G, Byrd D, Brodehl J. Cystatin C serum concentrations underestimate glomerular filtration rate in renal transplant recipients. Clin Chem. 1999;45:1866–8.PubMed
15.
Zurück zum Zitat Risch L, Herklotz R, Blumberg A, Huber AR. Effects of glucocorticoid immunosuppression on serum cystatin C concentrations in renal transplant patients. Clin Chem. 2001;47:2055–9.PubMed Risch L, Herklotz R, Blumberg A, Huber AR. Effects of glucocorticoid immunosuppression on serum cystatin C concentrations in renal transplant patients. Clin Chem. 2001;47:2055–9.PubMed
16.
Zurück zum Zitat Risch L, Huber AR. Glucocorticoids and increased serum cystatin C concentrations. Clin Chim Acta. 2002;320:133–4.PubMedCrossRef Risch L, Huber AR. Glucocorticoids and increased serum cystatin C concentrations. Clin Chim Acta. 2002;320:133–4.PubMedCrossRef
17.
Zurück zum Zitat Kos J, Stabuc B, Cimerman N, Brünner N. Serum cystatin C, a new marker of glomerular filtration rate, is increased during malignant progression. Clin Chem. 1998;44:2556–7.PubMed Kos J, Stabuc B, Cimerman N, Brünner N. Serum cystatin C, a new marker of glomerular filtration rate, is increased during malignant progression. Clin Chem. 1998;44:2556–7.PubMed
18.
Zurück zum Zitat Finney H, Williams AH, Price CP. Serum cystatin C in patients with myeloma. Clin Chim Acta. 2001;309:1–6.PubMedCrossRef Finney H, Williams AH, Price CP. Serum cystatin C in patients with myeloma. Clin Chim Acta. 2001;309:1–6.PubMedCrossRef
19.
Zurück zum Zitat Uemura O, Ushijima K, Nagai T, Yamada T, Hayakawa H, Shinkai Y, Kuwabara M. Reference serum creatinine levels determined by an enzymatic method in Japanese children: relationship to body length. Clin Exp Nephrol. 2009;13:585–8.PubMedCrossRef Uemura O, Ushijima K, Nagai T, Yamada T, Hayakawa H, Shinkai Y, Kuwabara M. Reference serum creatinine levels determined by an enzymatic method in Japanese children: relationship to body length. Clin Exp Nephrol. 2009;13:585–8.PubMedCrossRef
20.
Zurück zum Zitat 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.PubMedCrossRef 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.PubMedCrossRef
21.
Zurück zum Zitat Laterza OF, Price CP, Scott MG, Cystatin C. An improved estimator of glomerular filtration rate? Clin Chem. 2002;48:699–707.PubMed Laterza OF, Price CP, Scott MG, Cystatin C. An improved estimator of glomerular filtration rate? Clin Chem. 2002;48:699–707.PubMed
22.
Zurück zum Zitat Abrahamson M, Olafsson I, Palsdottir A, Ulvsbäck M, Lundwall A, Jensson O, Grubb A. Structure and expression of the human cystatin C gene. Biochem J. 1990;268:287–94.PubMedPubMedCentral Abrahamson M, Olafsson I, Palsdottir A, Ulvsbäck M, Lundwall A, Jensson O, Grubb A. Structure and expression of the human cystatin C gene. Biochem J. 1990;268:287–94.PubMedPubMedCentral
23.
Zurück zum Zitat Takuwa S, Ito Y, Ushijima K, Uchida K. Serum cystatin-C values in children by age and their fluctuation during dehydration. Pediatr Int. 2002;44:28–31.PubMedCrossRef Takuwa S, Ito Y, Ushijima K, Uchida K. Serum cystatin-C values in children by age and their fluctuation during dehydration. Pediatr Int. 2002;44:28–31.PubMedCrossRef
24.
Zurück zum Zitat Filler G, Lepage N. Should the Schwartz formula for estimation of GFR be replaced by cystatin C formula? Pediatr Nephrol. 2003;18:981–5.PubMedCrossRef Filler G, Lepage N. Should the Schwartz formula for estimation of GFR be replaced by cystatin C formula? Pediatr Nephrol. 2003;18:981–5.PubMedCrossRef
25.
Zurück zum Zitat Grubb A, Nyman U, Björk J, Lindström V, Rippe B, Sterner G, Christensson A. Simple cystatin C-based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the Counahan-Barratt prediction equations for children. Clin Chem. 2005;51:1420–31.PubMedCrossRef Grubb A, Nyman U, Björk J, Lindström V, Rippe B, Sterner G, Christensson A. Simple cystatin C-based prediction equations for glomerular filtration rate compared with the modification of diet in renal disease prediction equation for adults and the Schwartz and the Counahan-Barratt prediction equations for children. Clin Chem. 2005;51:1420–31.PubMedCrossRef
26.
Zurück zum Zitat Zappitelli M, Parvex P, Joseph L, Paradis G, Grey V, Lau S, Bell L. Derivation and validation of cystatin C-based prediction equations for GFR in children. Am J Kidney Dis. 2006;48:221–30.PubMedCrossRef Zappitelli M, Parvex P, Joseph L, Paradis G, Grey V, Lau S, Bell L. Derivation and validation of cystatin C-based prediction equations for GFR in children. Am J Kidney Dis. 2006;48:221–30.PubMedCrossRef
27.
Zurück zum Zitat Uemura O, Honda M, Matsuyama T, Ishikura K, Hataya H, Nagai T, Ikezumi Y, Fujita N, Ito S, Iijima 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.PubMedCrossRef Uemura O, Honda M, Matsuyama T, Ishikura K, Hataya H, Nagai T, Ikezumi Y, Fujita N, Ito S, Iijima 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.PubMedCrossRef
28.
Zurück zum Zitat Yata N, Uemura O, Honda M, Matsuyama T, Ishikura K, Hataya H, Nagai T, Ikezumi Y, Fujita N, Ito S, Iijima K, Saito M, Keneko T, Kitagawa T. Reference ranges for serum cystatin C measurements in Japanese children by using 4 automated assays. Clin Exp Nephrol. 2013 (Epub ahead of print). Yata N, Uemura O, Honda M, Matsuyama T, Ishikura K, Hataya H, Nagai T, Ikezumi Y, Fujita N, Ito S, Iijima K, Saito M, Keneko T, Kitagawa T. Reference ranges for serum cystatin C measurements in Japanese children by using 4 automated assays. Clin Exp Nephrol. 2013 (Epub ahead of print).
29.
Zurück zum Zitat Uemura O, Ushijima K, Nagai T, Yamada T, Yamakawa S, Hibi Y, Hayakawa H, Nabeta Y, Shinkai Y, Koike K, Kuwabara M. Measurements of serum cystatin C concentrations underestimate renal dysfunction in pediatric patients with chronic kidney disease. Clin Exp Nephrol. 2011;15:535–8.PubMedCrossRef Uemura O, Ushijima K, Nagai T, Yamada T, Yamakawa S, Hibi Y, Hayakawa H, Nabeta Y, Shinkai Y, Koike K, Kuwabara M. Measurements of serum cystatin C concentrations underestimate renal dysfunction in pediatric patients with chronic kidney disease. Clin Exp Nephrol. 2011;15:535–8.PubMedCrossRef
30.
Zurück zum Zitat Sjöström P, Tidman M, Jones I. Determination of the production rate and non-renal clearance of cystatin C and estimation of the glomerular filtration rate from the serum concentration of cystatin C in humans. Scand J Clin Lab Invest. 2005;65:111–24.PubMedCrossRef Sjöström P, Tidman M, Jones I. Determination of the production rate and non-renal clearance of cystatin C and estimation of the glomerular filtration rate from the serum concentration of cystatin C in humans. Scand J Clin Lab Invest. 2005;65:111–24.PubMedCrossRef
Metadaten
Titel
Cystatin C-based equation for estimating glomerular filtration rate in Japanese children and adolescents
verfasst von
Osamu Uemura
Takuhito Nagai
Kenji Ishikura
Shuichi Ito
Hiroshi Hataya
Yoshimitsu Gotoh
Naoya Fujita
Yuko Akioka
Tetsuji Kaneko
Masataka Honda
Publikationsdatum
01.10.2014
Verlag
Springer Japan
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 5/2014
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-013-0910-9

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