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

 Beom Seok Kim  ;  Yong Kyu Lee  ;  Hoon Young Choi  ;  Seung Ok Choi  ;  Sug Kyun Shin  ;  Sung Kyu Ha  ;  Kang Wook Lee  ;  Yang Wook Kim  ;  Yong Lim Kim  ;  Yoshinari Yasuda  ;  Enyu Imai  ;  Masaru Horio  ;  Yasuhiko Tomino  ;  Seiichi Matsuo  ;  Ho Yung Lee 
 CLINICAL LABORATORY, Vol.84(6) : 331-338, 2015 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Albuminuria/metabolism ; Algorithms ; Asian Continental Ancestry Group* ; Bias ; Blood Urea Nitrogen ; Creatinine/blood ; Creatinine/urine ; Female ; Follow-Up Studies ; Glomerular Filtration Rate/physiology* ; Humans ; Inulin/blood ; Inulin/metabolism* ; Inulin/urine ; Japan ; Kidney Function Tests/statistics & numerical data* ; Male ; Middle Aged ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/urine ; Republic of Korea/ethnology ; Serum Albumin/analysis ; Young Adult
glomerular filtration rate ; Korean ; inulin clearance ; serum creatinine
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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Choi, Hoon Young(최훈영) ORCID logo https://orcid.org/0000-0002-4245-0339
Ha, Sung Kyu(하성규)
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