Uemura Osamu, Yokoyama Hitoshi, Ishikura Kenji, Gotoh Yoshimitsu, Sato Hiroshi, Sugiyama Hitoshi, Honda Masataka, Matsuo Seiichi
Division of Clinical Medicine, Japanese Red Cross Toyota College of Nursing, Toyota, Japan.
Division of Nephrology, Kanazawa Medical University School of Medicine, Kanazawa, Japan.
Nephrology (Carlton). 2017 Jun;22(6):494-497. doi: 10.1111/nep.12982.
There are two different Japanese serum creatinine-based equations for estimated glomerular filtration rate (eGFR), for adults and paediatric patients, with both equations deemed applicable to 18-year-old subjects. This study assessed the relative accuracy of the two equations in assessing eGFR in patients aged 18 years with chronic kidney disease. A total of 3042 patients (1679 males and 1363 females), aged 2-20 years, who were registered in the Japan Renal Biopsy Registry or the Japan Kidney Disease Registry between 2007 and 2013 were evaluated. eGFR values derived from formulas for children (Uemura's formula) and adults (the 3-variable Japanese formula) were calculated and compared, especially in patients aged 18 years. At all ages, but especially at younger ages, eGFR was significantly higher when calculated with the adult than the paediatric formula. This finding was also observed in 18-year-old adolescents with eGFR <90 mL/min per 1.73 m (P = 0.026). However, the mean difference between the two calculated eGFRs was only 2.79 mL/min per 1.73 m . These findings indicate that both creatinine-based equations used to calculate eGFR rate in Japanese children and adults with chronic kidney disease could be used to determine eGFR in 18-year-old subjects, with the difference between the two within permissible levels for clinical use.
日本有两种基于血清肌酐的估算肾小球滤过率(eGFR)的公式,分别适用于成人和儿童患者,这两种公式都被认为适用于18岁的受试者。本研究评估了这两种公式在评估18岁慢性肾脏病患者eGFR时的相对准确性。对2007年至2013年期间登记在日本肾活检登记处或日本肾脏病登记处的3042例年龄在2至20岁的患者(1679例男性和1363例女性)进行了评估。计算并比较了根据儿童公式(上村公式)和成人公式(日本三变量公式)得出的eGFR值,特别是在18岁的患者中。在所有年龄段,尤其是在较年轻的年龄段,用成人公式计算的eGFR显著高于用儿童公式计算的eGFR。在eGFR<90 mL/(min·1.73 m²)的18岁青少年中也观察到了这一结果(P = 0.026)。然而,两种计算出的eGFR的平均差异仅为2.79 mL/(min·1.73 m²)。这些结果表明,用于计算日本慢性肾脏病儿童和成人eGFR率的两种基于肌酐的公式均可用于确定18岁受试者的eGFR,两者之间的差异在临床使用的允许范围内。