Revised Equations for Estimated GFR From Serum Creatinine in Japan

Japanese equation for estimated GFR

Research output: Contribution to journalArticle

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Abstract

Background: Estimation of glomerular filtration rate (GFR) is limited by differences in creatinine generation among ethnicities. Our previously reported GFR-estimating equations for Japanese had limitations because all participants had a GFR less than 90 mL/min/1.73 m2 and serum creatinine was assayed in different laboratories. Study Design: Diagnostic test study using a prospective cross-sectional design. New equations were developed in 413 participants and validated in 350 participants. All samples were assayed in a central laboratory. Setting & Participants: Hospitalized Japanese patients in 80 medical centers. Patients had not participated in the previous study. Reference Test: Measured GFR (mGFR) computed from inulin clearance. Index Test: Estimated GFR (eGFR) by using the modified isotope dilution mass spectrometry (IDMS)-traceable 4-variable Modification of Diet in Renal Disease (MDRD) Study equation using the previous Japanese Society of Nephrology Chronic Kidney Disease Initiative (JSN-CKDI) coefficient of 0.741 (equation 1), the previous JSN-CKDI equation (equation 2), and new equations derived in the development data set: modified MDRD Study using a new Japanese coefficient (equation 3), and a 3-variable Japanese equation (equation 4). Measurements: Performance of equations was assessed by means of bias (eGFR-mGFR), accuracy (percentage of estimates within 15% or 30% of mGFR), root mean squared error, and correlation coefficient. Results: In the development data set, the new Japanese coefficient was 0.808 (95% confidence interval, 0.728 to 0.829) for the IDMS-MDRD Study equation (equation 3), and the 3-variable Japanese equation (equation 4) was eGFR (mL/min/1.73 m2) = 194 × Serum creatinine-1.094 × Age-0.287 × 0.739 (if female). In the validation data set, bias was -1.3 ± 19.4 versus -5.9 ± 19.0 mL/min/1.73 m2 (P = 0.002), and accuracy within 30% of mGFR was 73% versus 72% (P = 0.6) for equation 3 versus equation 1 and-2.1±19.0 versus-7.9±18.7 mL/min/1.73m2 (P<0.001) and 75% versus 73% (P= 0.06) for equation 4 versus equation 2 (P = 0.06), respectively. Limitation: Most study participants had chronic kidney disease, and some may have had changing GFRs. Conclusion: The new Japanese coefficient for the modified IDMS-MDRD Study equation and the new Japanese equation are more accurate for the Japanese population than the previously reported equations. Am J Kidney Dis 53:982-992.

Original languageEnglish
Pages (from-to)982-992
Number of pages11
JournalAmerican Journal of Kidney Diseases
Volume53
Issue number6
DOIs
Publication statusPublished - 01-06-2009

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Diet Therapy
Glomerular Filtration Rate
Creatinine
Japan
Kidney
Chronic Renal Insufficiency
Isotopes
Mass Spectrometry
Serum
Nephrology
Inulin
Routine Diagnostic Tests
Confidence Intervals
Population
Datasets

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Japanese equation for estimated GFR. / Revised Equations for Estimated GFR From Serum Creatinine in Japan. In: American Journal of Kidney Diseases. 2009 ; Vol. 53, No. 6. pp. 982-992.
@article{fcadc595dbe44c0c9e275ffffad6e632,
title = "Revised Equations for Estimated GFR From Serum Creatinine in Japan",
abstract = "Background: Estimation of glomerular filtration rate (GFR) is limited by differences in creatinine generation among ethnicities. Our previously reported GFR-estimating equations for Japanese had limitations because all participants had a GFR less than 90 mL/min/1.73 m2 and serum creatinine was assayed in different laboratories. Study Design: Diagnostic test study using a prospective cross-sectional design. New equations were developed in 413 participants and validated in 350 participants. All samples were assayed in a central laboratory. Setting & Participants: Hospitalized Japanese patients in 80 medical centers. Patients had not participated in the previous study. Reference Test: Measured GFR (mGFR) computed from inulin clearance. Index Test: Estimated GFR (eGFR) by using the modified isotope dilution mass spectrometry (IDMS)-traceable 4-variable Modification of Diet in Renal Disease (MDRD) Study equation using the previous Japanese Society of Nephrology Chronic Kidney Disease Initiative (JSN-CKDI) coefficient of 0.741 (equation 1), the previous JSN-CKDI equation (equation 2), and new equations derived in the development data set: modified MDRD Study using a new Japanese coefficient (equation 3), and a 3-variable Japanese equation (equation 4). Measurements: Performance of equations was assessed by means of bias (eGFR-mGFR), accuracy (percentage of estimates within 15{\%} or 30{\%} of mGFR), root mean squared error, and correlation coefficient. Results: In the development data set, the new Japanese coefficient was 0.808 (95{\%} confidence interval, 0.728 to 0.829) for the IDMS-MDRD Study equation (equation 3), and the 3-variable Japanese equation (equation 4) was eGFR (mL/min/1.73 m2) = 194 × Serum creatinine-1.094 × Age-0.287 × 0.739 (if female). In the validation data set, bias was -1.3 ± 19.4 versus -5.9 ± 19.0 mL/min/1.73 m2 (P = 0.002), and accuracy within 30{\%} of mGFR was 73{\%} versus 72{\%} (P = 0.6) for equation 3 versus equation 1 and-2.1±19.0 versus-7.9±18.7 mL/min/1.73m2 (P<0.001) and 75{\%} versus 73{\%} (P= 0.06) for equation 4 versus equation 2 (P = 0.06), respectively. Limitation: Most study participants had chronic kidney disease, and some may have had changing GFRs. Conclusion: The new Japanese coefficient for the modified IDMS-MDRD Study equation and the new Japanese equation are more accurate for the Japanese population than the previously reported equations. Am J Kidney Dis 53:982-992.",
author = "{Japanese equation for estimated GFR} and Seiichi Matsuo and Enyu Imai and Masaru Horio and Yoshinari Yasuda and Kimio Tomita and Kosaku Nitta and Kunihiro Yamagata and Yasuhiko Tomino and Hitoshi Yokoyama and Akira Hishida and Kenjiro Kikuchi and Masakazu Haneda and Seiji Hashimoto and Nobuyuki Ura and Sadayoshi Ito and Hiroshi Sato and Tsuyoshi Watanabe and Yasuhiro Ando and Eiji Kusano and Yoshihisa Nojima and Chie Saitoh and Tatsuo Shiigai and Yoshitaka Maeda and Hiromichi Suzuki and Yusuke Watanabe and Tetsuya Mitarai and Hajime Hasegawa and Toshiro Fujita and Tatsuo Hosoya and Koichi Matsumoto and Takayuki Fujita and Tsutomu Sanaka and Eiichiro Kanda and Sei Sasaki and Toshiyuki Nakano and Tadao Akizawa and Hirokazu Honda and Yoshihiko Inoue and Ashio Yoshimura and Megumu Fukunaga and Hiroshi Tsuji and Yasushi Ohashi and Hideaki Nakajima and Shunya Uchida and Akira Yamada and Satoshi Umemura and Mai Yanagi and Hiro Yamakawa and Kenjiro Kimura and Daijo Inaguma",
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}

Revised Equations for Estimated GFR From Serum Creatinine in Japan. / Japanese equation for estimated GFR.

In: American Journal of Kidney Diseases, Vol. 53, No. 6, 01.06.2009, p. 982-992.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Revised Equations for Estimated GFR From Serum Creatinine in Japan

AU - Japanese equation for estimated GFR

AU - Matsuo, Seiichi

AU - Imai, Enyu

AU - Horio, Masaru

AU - Yasuda, Yoshinari

AU - Tomita, Kimio

AU - Nitta, Kosaku

AU - Yamagata, Kunihiro

AU - Tomino, Yasuhiko

AU - Yokoyama, Hitoshi

AU - Hishida, Akira

AU - Kikuchi, Kenjiro

AU - Haneda, Masakazu

AU - Hashimoto, Seiji

AU - Ura, Nobuyuki

AU - Ito, Sadayoshi

AU - Sato, Hiroshi

AU - Watanabe, Tsuyoshi

AU - Ando, Yasuhiro

AU - Kusano, Eiji

AU - Nojima, Yoshihisa

AU - Saitoh, Chie

AU - Shiigai, Tatsuo

AU - Maeda, Yoshitaka

AU - Suzuki, Hiromichi

AU - Watanabe, Yusuke

AU - Mitarai, Tetsuya

AU - Hasegawa, Hajime

AU - Fujita, Toshiro

AU - Hosoya, Tatsuo

AU - Matsumoto, Koichi

AU - Fujita, Takayuki

AU - Sanaka, Tsutomu

AU - Kanda, Eiichiro

AU - Sasaki, Sei

AU - Nakano, Toshiyuki

AU - Akizawa, Tadao

AU - Honda, Hirokazu

AU - Inoue, Yoshihiko

AU - Yoshimura, Ashio

AU - Fukunaga, Megumu

AU - Tsuji, Hiroshi

AU - Ohashi, Yasushi

AU - Nakajima, Hideaki

AU - Uchida, Shunya

AU - Yamada, Akira

AU - Umemura, Satoshi

AU - Yanagi, Mai

AU - Yamakawa, Hiro

AU - Kimura, Kenjiro

AU - Inaguma, Daijo

PY - 2009/6/1

Y1 - 2009/6/1

N2 - Background: Estimation of glomerular filtration rate (GFR) is limited by differences in creatinine generation among ethnicities. Our previously reported GFR-estimating equations for Japanese had limitations because all participants had a GFR less than 90 mL/min/1.73 m2 and serum creatinine was assayed in different laboratories. Study Design: Diagnostic test study using a prospective cross-sectional design. New equations were developed in 413 participants and validated in 350 participants. All samples were assayed in a central laboratory. Setting & Participants: Hospitalized Japanese patients in 80 medical centers. Patients had not participated in the previous study. Reference Test: Measured GFR (mGFR) computed from inulin clearance. Index Test: Estimated GFR (eGFR) by using the modified isotope dilution mass spectrometry (IDMS)-traceable 4-variable Modification of Diet in Renal Disease (MDRD) Study equation using the previous Japanese Society of Nephrology Chronic Kidney Disease Initiative (JSN-CKDI) coefficient of 0.741 (equation 1), the previous JSN-CKDI equation (equation 2), and new equations derived in the development data set: modified MDRD Study using a new Japanese coefficient (equation 3), and a 3-variable Japanese equation (equation 4). Measurements: Performance of equations was assessed by means of bias (eGFR-mGFR), accuracy (percentage of estimates within 15% or 30% of mGFR), root mean squared error, and correlation coefficient. Results: In the development data set, the new Japanese coefficient was 0.808 (95% confidence interval, 0.728 to 0.829) for the IDMS-MDRD Study equation (equation 3), and the 3-variable Japanese equation (equation 4) was eGFR (mL/min/1.73 m2) = 194 × Serum creatinine-1.094 × Age-0.287 × 0.739 (if female). In the validation data set, bias was -1.3 ± 19.4 versus -5.9 ± 19.0 mL/min/1.73 m2 (P = 0.002), and accuracy within 30% of mGFR was 73% versus 72% (P = 0.6) for equation 3 versus equation 1 and-2.1±19.0 versus-7.9±18.7 mL/min/1.73m2 (P<0.001) and 75% versus 73% (P= 0.06) for equation 4 versus equation 2 (P = 0.06), respectively. Limitation: Most study participants had chronic kidney disease, and some may have had changing GFRs. Conclusion: The new Japanese coefficient for the modified IDMS-MDRD Study equation and the new Japanese equation are more accurate for the Japanese population than the previously reported equations. Am J Kidney Dis 53:982-992.

AB - Background: Estimation of glomerular filtration rate (GFR) is limited by differences in creatinine generation among ethnicities. Our previously reported GFR-estimating equations for Japanese had limitations because all participants had a GFR less than 90 mL/min/1.73 m2 and serum creatinine was assayed in different laboratories. Study Design: Diagnostic test study using a prospective cross-sectional design. New equations were developed in 413 participants and validated in 350 participants. All samples were assayed in a central laboratory. Setting & Participants: Hospitalized Japanese patients in 80 medical centers. Patients had not participated in the previous study. Reference Test: Measured GFR (mGFR) computed from inulin clearance. Index Test: Estimated GFR (eGFR) by using the modified isotope dilution mass spectrometry (IDMS)-traceable 4-variable Modification of Diet in Renal Disease (MDRD) Study equation using the previous Japanese Society of Nephrology Chronic Kidney Disease Initiative (JSN-CKDI) coefficient of 0.741 (equation 1), the previous JSN-CKDI equation (equation 2), and new equations derived in the development data set: modified MDRD Study using a new Japanese coefficient (equation 3), and a 3-variable Japanese equation (equation 4). Measurements: Performance of equations was assessed by means of bias (eGFR-mGFR), accuracy (percentage of estimates within 15% or 30% of mGFR), root mean squared error, and correlation coefficient. Results: In the development data set, the new Japanese coefficient was 0.808 (95% confidence interval, 0.728 to 0.829) for the IDMS-MDRD Study equation (equation 3), and the 3-variable Japanese equation (equation 4) was eGFR (mL/min/1.73 m2) = 194 × Serum creatinine-1.094 × Age-0.287 × 0.739 (if female). In the validation data set, bias was -1.3 ± 19.4 versus -5.9 ± 19.0 mL/min/1.73 m2 (P = 0.002), and accuracy within 30% of mGFR was 73% versus 72% (P = 0.6) for equation 3 versus equation 1 and-2.1±19.0 versus-7.9±18.7 mL/min/1.73m2 (P<0.001) and 75% versus 73% (P= 0.06) for equation 4 versus equation 2 (P = 0.06), respectively. Limitation: Most study participants had chronic kidney disease, and some may have had changing GFRs. Conclusion: The new Japanese coefficient for the modified IDMS-MDRD Study equation and the new Japanese equation are more accurate for the Japanese population than the previously reported equations. Am J Kidney Dis 53:982-992.

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