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Clinical Nephrology
Article . 2015 . Peer-reviewed
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Is the new GFR equation using inulin clearance a more accurate method for Asian patients?

Authors: Hoon Young Choi; Beom Seok Kim; Sug Kyun Shin; Yong Kyu Lee; Yoshinari Yasuda; Yasuhiko Tomino; Kang Wook Lee; +8 Authors

Is the new GFR equation using inulin clearance a more accurate method for Asian patients?

Abstract

Recently, a new glomerular filtration rate (GFR) equation for the Japanese population was proposed using measured inulin clearance. To expand its applicability to other Asian populations, we performed a comparative study in the Korean population. Inulin clearance was measured in 166 patients from seven participating medical centers in Korea. Patient's sera and urine were collected, and baseline clinical characteristics were measured to provide an estimated GFR (eGFR) by the Japanese GFR equation using inulin clearance (Japanese-GFR equation), the Modification of Diet in Renal Disease (MDRD) study equation, and the Chronic Kidney Disease - Epidemiology Collaboration (CKD-EPI) equation. We compared the results to determine which equation best estimated the measured GFR (mGFR). Accuracy (95% CI) within 30% of mGFR by the Japanese-GFR equation, the CKD-EPI equation and the MDRD study equation were 66 (58 - 72), 51 (43 - 58), and 55 (47 - 62)%, respectively. Bias (mGFR minus eGFR) were 3.4 ± 22.4, -12.0 ± 22.1, and -9.7 ± 23.8 mL/min/1.73 m2, respectively. The accuracy of the Japanese-GFR equation was significantly better than MDRD study equation in subjects with mGFR < 60 mL/min/1.73 m2 and in total subjects. The bias of the Japanese-GFR equation was significantly smaller compared with other two equations in total subjects. The Japanese-GFR equation has a higher accuracy with less bias than the other equations in estimating GFR in Korean populations. Further studies are required to determine if the current Japanese-GFR equation could represent the standard eGFR for other Asian populations.

Keywords

Kidney Function Tests/statistics & numerical data*, Adult, Male, Adolescent, Republic of Korea/ethnology, 610, Korean, Kidney Function Tests, Glomerular Filtration Rate/physiology*, inulin clearance, serum creatinine, Inulin/urine, Blood Urea Nitrogen, Inulin/metabolism*, Young Adult, Asian People, Bias, Japan, Creatinine/urine, 80 and over, Albuminuria, Humans, Renal Insufficiency, Renal Insufficiency, Chronic, Albuminuria/metabolism, Serum Albumin/analysis, Aged, Aged, 80 and over, Asian Continental Ancestry Group*, glomerular filtration rate, Inulin, 600, Creatinine/blood, Middle Aged, Chronic/blood, Creatinine, Inulin/blood, Chronic/urine, Female, Algorithms, Follow-Up Studies, Glomerular Filtration Rate

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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Average
Average
Average
Green