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Performance of the Japanese GFR equation in potential kidney donors

Masaru Horio1, Yoshinari Yasuda, Jyunya Kaimori

  • 1Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. horio@sahs.med.osaka-u.ac.jp

Clinical and Experimental Nephrology
|January 25, 2012
PubMed

Insights

The Japanese GFR equation underestimates kidney function in potential kidney donors, unlike in chronic kidney disease (CKD) patients. Higher creatinine generation in donors contributes to this underestimation.

Area of Science:

  • Nephrology
  • Renal Physiology
  • Biomarkers

Background:

  • The Japanese GFR equation was primarily developed using chronic kidney disease (CKD) patient data.
  • Limited inclusion of healthy individuals in its development and validation poses potential performance issues.
  • Assessing the equation's accuracy in potential kidney donors is crucial for clinical application.

Purpose of the Study:

  • To evaluate the performance of the Japanese GFR equation in estimating glomerular filtration rate (GFR) in potential kidney donors.
  • To compare the equation's accuracy in kidney donors versus CKD subjects.
  • To investigate factors contributing to any observed discrepancies.

Main Methods:

  • Inclusion of 113 potential kidney donors and comparison with previously reported data from 340 CKD subjects.
  • Measurement of GFR using inulin clearance (mGFR) as the gold standard.
  • Calculation of estimated GFR (eGFR) using the Japanese GFR equation.
  • Analysis of bias (eGFR - mGFR) and urinary creatinine excretion.

Main Results:

  • No significant difference between eGFR and mGFR was found in CKD subjects.
  • The Japanese GFR equation significantly underestimated mGFR in potential kidney donors (78.9 vs. 93.6 ml/min/1.73 m²).
  • Potential kidney donors exhibited significantly greater bias and higher creatinine excretion per body weight compared to CKD subjects.

Conclusions:

  • The Japanese GFR equation is inaccurate for estimating GFR in potential kidney donors.
  • Elevated creatinine generation in kidney donors, compared to CKD patients, likely explains the underestimation of GFR.
  • Clinical use of the Japanese GFR equation in potential kidney donors requires careful consideration due to potential underestimation.
Abstract

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