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Age, gender, and body length effects on reference serum creatinine levels determined by an enzymatic method in
Osamu Uemura1,2, Masataka Honda3, Takeshi Matsuyama3
1The Japanese Society for Pediatric Nephrology, The Committee of Measures for Pediatric CKD, Tokyo, Japan. o_uemura@hkg.odn.ne.jp.
Insights
This study establishes reference serum creatinine (Cr) values for Japanese children using enzymatic methods. The findings provide age- and sex-specific equations for evaluating renal function in pediatric populations.
Area of Science:
- Pediatric Nephrology
- Clinical Chemistry
- Biomarker Analysis
Background:
- Enzymatic methods are replacing the Jaffe method for serum creatinine (Cr) measurement.
- Establishing reliable reference values is crucial for assessing renal function in Japanese children using these new methods.
Purpose of the Study:
- To determine reference serum Cr values in healthy Japanese children using an enzymatic method.
- To develop equations for estimating serum Cr levels based on age and gender.
Main Methods:
- Serum Cr was measured in 1151 healthy Japanese children (1 month to 18 years) via an enzymatic method.
- Exclusion criteria ensured a healthy cohort, free from conditions affecting renal function.
Main Results:
- Serum Cr medians increased with age, with accelerated growth in adolescent males.
- Linear regression equations were derived for children aged 2-11 years.
- Quintic regression equations were developed for all age groups, stratified by gender.
Conclusions:
- Reference serum Cr levels are influenced by age, gender, and body length in children.
- Developed regression equations are applicable for renal function screening in Asian and Japanese children.
Background:
Enzymatic methods have recently been used to measure creatinine (Cr) instead of the Jaffe method. Therefore, it is necessary to determine the reference serum Cr value for these enzymatic methods to evaluate renal function in Japanese children.
Methods:
To determine reference values of serum Cr in Japanese children, 1151 children (517 male, 634 female) aged between 1 month and 18 years had their serum Cr values measured by an enzymatic method. To be included in the study the children had to be without kidney disease, urogenital disease, infectious disease, inflammatory disease, dehydration, muscular disease, anomaly syndrome, cardiovascular disease, malignant disease, hypertension, liver or pancreas disease, or pregnancy.
Results:
The medians of reference values increased gradually with age, i.e., 0.30 mg/dl at 4 years old and 0.41 mg/dl at 10 years old. In adolescence, they increased significantly more rapidly in males than in females. We found a linear regression equation capable of estimating the reference value of serum Cr in children aged 2-11 years, and quintic regression equations capable of estimating the reference values of serum Cr in male and female children of all ages.
Conclusion:
The reference serum Cr levels determined by an enzymatic method related to age, gender, and body length, and our linear and polynomial equations showing the relationship between body length and serum Cr level will be applicable for screening of renal function in Asian as well as Japanese children.
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