Related Experiment Video
Updated: May 5, 2026
Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat
Published on: July 26, 2015
Cystatin C-based equation for estimating glomerular filtration rate in Japanese children and adolescents
Osamu Uemura1, Takuhito Nagai, Kenji Ishikura
1The Japanese Society for Pediatric Nephrology, the Committee of Measures for Pediatric CKD, Tokyo, Japan, o_uemura@hkg.odn.ne.jp.
Insights
A new serum cystatin C (cysC)-based estimated glomerular filtration rate (eGFR) formula is effective for assessing kidney function in Japanese pediatric patients with chronic kidney disease (CKD). This method offers a reliable alternative to inulin clearance for evaluating renal function in children.
Area of Science:
- Pediatric Nephrology
- Biomarkers in Renal Disease
Background:
- Renal inulin clearance is the gold standard for kidney function assessment but is challenging in pediatric populations, particularly in young children or those with bladder dysfunction.
- Serum cystatin C (cysC) offers a promising alternative for estimating glomerular filtration rate (eGFR).
Purpose of the Study:
- To evaluate the applicability of a new serum cysC-based eGFR formula for assessing renal function in Japanese children and adolescents, including infants with chronic kidney disease (CKD).
Main Methods:
- Measured inulin clearance and serum cysC levels in 135 pediatric CKD patients (1 month to 18 years).
- Utilized colloidal gold immunoassay for standardized serum cysC measurement.
- Determined a novel cysC-based eGFR formula specific to Japanese pediatric CKD patients.
Main Results:
- Developed the equation: inulin GFR (mL/min/1.73 m(2)) = 104.1 × 1/serum cysC (mg/L) - 7.80.
- Validated the cysC-based eGFR formula against Japanese adult standards.
- Found that adult eGFR formulas significantly underestimated GFR by approximately 8% in pediatric CKD patients.
Conclusions:
- The newly developed cysC-based eGFR formula is a useful tool for clinical screening of renal function in Japanese pediatric patients, including infants with CKD.
- This formula provides a more accurate assessment of kidney function compared to existing adult formulas in this population.
Background:
Renal inulin clearance is the gold standard for evaluation of kidney function, but is compromised by problems of collecting urine samples in children, especially those <6 years or with a bladder dysfunction. Therefore, we should utilize the serum cystatin C (cysC)-based estimated glomerular filtration rate (eGFR) for measuring serum cysC. The purpose of the present study is to determine the applicability of the new serum cysC-based eGFR in Japanese children and adolescents, including infants with chronic kidney disease (CKD), for evaluation of renal function.
Methods:
Inulin clearance and standardized serum cysC level determined by the colloidal gold immunoassay were measured in 135 pediatric CKD patients between the ages of 1 month and 18 years with no underlying disease that affects renal function except CKD, to determine serum cysC-based eGFR in Japanese children and adolescents.
Results:
We showed the inulin clearance by expression of 1/serum cysC in pediatric CKD patients, which resulted in the equation: inulin GFR (mL/min/1.73 m(2)) = 104.1 × 1/serum cysC (mg/L) - 7.80. We also validated the cysC-based eGFR formula for Japanese adults. eGFR values obtained with the adult formula significantly underestimated GFR by approximately 8 % in children with CKD.
Conclusion:
We determined the new cysC-based eGFR formula is useful for clinical screening of renal function in Japanese children and adolescents, including infants.
Related Concept Videos
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
01:25Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance
01:28Glomerular Filtration Rate and its Regulation
GFR regulation involves two primary intrinsic controls: the myogenic and tubuloglomerular feedback mechanisms.
The myogenic...
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:02Renal Drug Excretion: Glomerular Filtration
Drugs gain access to the kidney via the renal artery, which progressively branches off into afferent arterioles....