Japanese journal of pediatric nephrology
Online ISSN : 1881-3933
Print ISSN : 0915-2245
ISSN-L : 0915-2245
Original Article
Estimated glomerular filtration rate in Japanese children calculated from creatinine is the closest to the measured glomerular filtration rate
Chikako Terano Osamu UemuraJun SadaRyo MasaokaNozomi AkiyamaMasatoshi YoshikaneHisaki KawamukaiKazuki TanakaNaoya Fujita
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JOURNAL OPEN ACCESS

2025 Volume 38 Article ID: oa.24-030

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Abstract

Background and Purpose: In Japan, estimated glomerular filtration rate (eGFR) based on creatinine (Cr), cystatin C (CysC), and β2-microglobulin (β2MG) is commonly used to evaluate kidney function in children. However, discrepancies between these eGFR values have been observed in clinical practice. This study aimed to investigate the consistency between the measured glomerular filtration rate (mGFR) using the inulin clearance test (Cin), eGFR values derived from Cr, CysC, and β2MG, as well as eGFR based on 24-hour creatinine clearance (CCr).

Methods: This retrospective study included 120 patients (83 boys) aged 3 months to 18 years with chronic kidney disease who underwent Cin testing at our hospital between 2016 and 2023. The mGFR values were compared with Cr-eGFR, CysC-eGFR, β2MG-eGFR, and CCr-eGFR for each subject. The mean error (ME) was calculated through Bland-Altman analysis to evaluate the validity of each estimate.

Results: A total of 167 Cin tests were conducted. The mean values (ml/min/1.73 m2) of each test were as follows: mGFR 63.5±32.6, Cr-eGFR 63.3±26.2, CysC-eGFR 68.8±28.3, β2MG-eGFR 87.3±40.5, and CCr-eGFR 57.4±26.9. The Cr-eGFR showed the greatest similarity to mGFR, with Bland-Altman analysis confirming that Cr-eGFR was the most valid and reliable method for estimating mGFR.

Conclusion: Cr-eGFR provides the most accurate estimate of mGFR compared to other methods. The reasons for the observed discrepancies and the potential need for new estimation formulas warrant further discussion.

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© 2025 The Japanese Society for Pediatric Nephrology

この記事はクリエイティブ・コモンズ [表示 - 非営利 - 継承 4.0 国際]ライセンスの下に提供されています。
https://creativecommons.org/licenses/by-nc-sa/4.0/deed.ja
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