Comparison of glomerular filtration rate estimating formulas among Japanese adults without kidney disease

Fujii, Ryosuke; Pattaro, Cristian; Tsuboi, Yoshiki; Ishihara, Yuya; Melotti, Roberto; Yamada, Hiroya; Ando, Yoshitaka; Ishikawa, Hiroaki; Ohashi, Koji; Hashimoto, Shuji; Hamajima, Nobuyuki; Barbieri, Giulia; Ghasemi-Semeskandeh, Dariush; Suzuki, Koji

doi:10.1016/j.clinbiochem.2022.10.011

Cited by 6 publications

(10 citation statements)

References 27 publications

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“…Third, there was measurement error because we estimated renal function using the revised Japanese equation [21][22][23] . Furthermore, inulin clearance values, which are considered the gold standard for measuring the GFR, were unavailable in this study owing to the time and cost involved and the nature of the annual health checkup conducted by the local government.…”

Section: Discussionmentioning

confidence: 99%

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Association between blood pressure and new onset of chronic kidney disease in non-diabetic Japanese adults: a population-based longitudinal study from 1998 to 2023

Okawa,

Mitsuhashi

2023

Preprint

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Hypertension is a risk factor for developing chronic kidney disease (CKD). Studies of adult participants in the USA reported that hypertension increased the risk of developing CKD even in the non-diabetic population. However, studies in non-diabetic populations are limited and additional studies in other races are required. This longitudinal study (1998–2023) aimed to evaluate the relationship between blood pressure (BP) levels and subsequent development of CKD in non-diabetic Japanese adults. CKD was defined as 60 mL/min/1.73 m2, and hypertension was classified into four levels according to the guidelines of the American College of Cardiology/American Heart Association. The Weibull accelerated failure time model was selected to estimate the effects of covariates on the survival time because the proportional hazard assumption was violated. Of the 7 363 (men: 40.3%) people in the final cohort, 2 498 (men: 40.1%) developed CKD after a mean follow-up of 7.99 person-years. Participants with elevated BP (systolic blood pressure [SBP] of 120–129 mmHg and diastolic blood pressure [DBP] <80 mmHg) and hypertension stage 2 (SBP ≥140 mmHg or DBP ≥90 mmHg) had a 9% (95% confidence interval [CI]: 1%–16%) and 11% (95% CI: 5%–17%) shorter survival time to CKD onset, respectively, than those with normal BP (SBP <120 mmHg and DBP <80 mmHg). However, hypertension stage 1 (SBP of 130–139 mmHg or DBP of 80–89 mmHg) was not associated with CKD onset. Therefore, in a relatively healthy Asian population, controlling BP to an appropriate range reduces the risk of developing CKD.

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Section: Discussionmentioning

confidence: 99%

“…= 194 × 𝑠𝑒𝑟𝑢𝑚 𝑐𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛𝑒 (𝑚𝑔/𝑑𝐿) "#.%&' × 𝑎𝑔𝑒 (𝑦𝑒𝑎𝑟𝑠) "%.! () (× 0.739 𝑖𝑓 𝑓𝑒𝑚𝑎𝑙𝑒) [21][22][23] . Prevalent CKD was defined as an eGFR <60 mL/min/1.73 m 2 according to the Kidney Disease Improving Global Outcome 2 .…”

Section: Outcomementioning

confidence: 99%

Association between blood pressure and new onset of chronic kidney disease in non-diabetic Japanese adults: a population-based longitudinal study from 1998 to 2023

Okawa,

Mitsuhashi

2023

Preprint

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“…The estimated glomerular filtration rate (eGFR) was used as a measure of renal function 2 . We used the three-variable revised Japanese equation to estimate glomerular filtration rate (GFR): eGFR(mL/min/1.73m 2 ) = 194 x serum creatinine(mg/dL) -l.O94 x age (years) -O.287 (x 0.739, iffemale) 2,23–25 . Prevalent CKD was defined as eGFR <60 mL/min/1.73 m 22 .…”

Section: Methodsmentioning

confidence: 99%

“…The estimated glomerular filtration rate (eGFR) was used as a measure of renal function 2 . We used the three-variable revised Japanese equation to estimate glomerular filtration rate (GFR) [27][28][29] : ‫݉37.1/݊݅݉/ܮ݉‪ܴሺ‬ܨܩ݁‬ ଶ ሻ ൌ 194 ൈ ‫݉ݑݎ݁ݏ‬ ‫/݃݉‪݅݊݅݊݁ሺ‬ݐܽ݁ݎܿ‬ ݀‫ܮ‬ሻ ିଵ.ଽସ ൈ ܽ݃݁ ‫‪ሻ‬ݏݎܽ݁ݕ‪ሺ‬‬ ି.ଶ଼ ሺൈ 0.739, ݂݂݈݅݁݉ܽ݁ሻ. Prevalent CKD was defined as eGFR < 60 mL/min/1.73 m 22 .…”

Section: Outcomementioning

confidence: 99%

Is obesity in the Asia-Pacific body mass index classification associated with the development of chronic kidney disease in non-diabetic Japanese men and women?

Okawa,

Mitsuhashi,

Tsuda

2024

Preprint

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Background/ObjectivesObesity is a risk factor for the development of chronic kidney disease (CKD). However, little is known about the relationship between the Asia-Pacific body mass index classification (Asia-Pacific classification) and the subsequent development of CKD in non-diabetic Asian men and women.Subjects/MethodsBody mass index (BMI) was categorized in accordance with the Asia-Pacific classification: underweight (< 18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obesity class I (25.0–29.9 kg/m2), and obesity class II (≥ 30.0 kg/m2). Using administrative checkup data for non-diabetic Japanese adults (1998–2023), we assessed the relationship between the Asia-Pacific classification and new-onset CKD by sex. The Weibull accelerated failure time model was selected because the proportional hazards assumption was violated.ResultsIn total, 34.2% of 3,098 men and 34.8% of 4,391 women had newly developed CKD. The mean follow-up time was 7.41 person-years for men and 8.25 person-years for women. Compared with those of normal weight, obesity class I was associated with a 6% (95% confidence interval [CI]: 2%–10%) shorter time to CKD development in men and a 6% (95% CI: 2%–9%) shorter time to CKD development in women. Obesity class II was associated with the shortest survival to CKD onset by point estimate in men but had an almost null value in women (i.e., 95% CIs crossed 1 in all of the models).ConclusionsAmong non-diabetic Japanese men and women, obesity class I in the Asia-Pacific classification was associated with a shorter survival time to CKD onset than normal weight. Low point estimates for obesity class II suggested a dose-response relationship in men but a less clear relationship in women. The conventional cutoff value for obesity, BMI ≥ 30.0 kg/m2, may be too high a risk factor for new-onset CKD in non-diabetic Asians, regardless of sex.

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“…Cys may reflect inflammation [ 17 ] and thyroid hormone metabolism [ 18 ]. eGFRcre and eGFRcys are not always consistent with each other and they may differ in terms of CKD classification [ 19 , 20 ]. Combining SCr and Cys together usually improves estimate of the true kidney function level [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Structural equation modeling (SEM) of kidney function markers and longitudinal CVD risk assessment

et al. 2023

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Lower kidney function is known to enhance cardiovascular disease (CVD) risk. It is unclear which estimated glomerular filtration rate (eGFR) equation best predict an increased CVD risk and if prediction can be improved by integration of multiple kidney function markers. We performed structural equation modeling (SEM) of kidney markers and compared the performance of the resulting pooled indexes with established eGFR equations to predict CVD risk in a 10-year longitudinal population-based design. We split the study sample into a set of participants with only baseline data (n = 647; model-building set) and a set with longitudinal data (n = 670; longitudinal set). In the model-building set, we fitted five SEM models based on serum creatinine or creatinine-based eGFR (eGFRcre), cystatin C or cystatin-based eGFR (eGFRcys), uric acid (UA), and blood urea nitrogen (BUN). In the longitudinal set, 10-year incident CVD risk was defined as a Framingham risk score (FRS)>5% and a pooled cohort equation (PCE)>5%. Predictive performances of the different kidney function indexes were compared using the C-statistic and the DeLong test. In the longitudinal set, a SEM-based estimate of latent kidney function based on eGFRcre, eGFRcys, UA, and BUN showed better prediction performance for both FRS>5% (C-statistic: 0.70; 95% CI: 0.65–0.74) and PCE>5% (C-statistic: 0.75; 95%CI: 0.71–0.79) than other SEM models and different eGFR formulas (DeLong test p-values<3.21×10−6 for FRS>5% and <1.49×10−9 for PCE>5%, respectively). However, the new derived marker could not outperform eGFRcys (DeLong test p-values = 0.88 for FRS>5% and 0.20 for PCE>5%, respectively). SEM is a promising approach to identify latent kidney function signatures. However, for incident CVD risk prediction, eGFRcys could still be preferrable given its simpler derivation.

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Comparison of glomerular filtration rate estimating formulas among Japanese adults without kidney disease

Cited by 6 publications

References 27 publications

Association between blood pressure and new onset of chronic kidney disease in non-diabetic Japanese adults: a population-based longitudinal study from 1998 to 2023

Association between blood pressure and new onset of chronic kidney disease in non-diabetic Japanese adults: a population-based longitudinal study from 1998 to 2023

Is obesity in the Asia-Pacific body mass index classification associated with the development of chronic kidney disease in non-diabetic Japanese men and women?

Structural equation modeling (SEM) of kidney function markers and longitudinal CVD risk assessment

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