Validity evaluation of rounding up serum creatinine values below 0.6 mg/dL to 0.6 mg/dL to estimate renal function in sarcopenia

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  • Utsumi Sara
    Department of Clinical Pharmacology, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
  • Maeda Keisuke
    National Center for Geriatrics and Gerontology, Aichi, Japan
  • Kubota Jota
    Department of Nutrition and Dysphagia Rehabilitation, Tamana Regional Health Medical Center, Kumamoto, Japan
  • Nakatani Sakura
    Department of Hospital Pharmacy, Hospital of the University of Occupational and Environmental Health, Fukuoka, Japan
  • Harada Yoshihiko
    Department of Clinical Pharmacology, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
  • Narita Yuki
    Department of Pharmacy, Kumamoto University Hospital, Kumamoto, Japan Department of Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
  • Saruwatari Junji
    Department of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto, Japan
  • Kondo Yuki
    Department of Clinical Chemistry and informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
  • Ishitsuka Yoichi
    Department of Clinical Pharmacology, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan Department of Clinical Chemistry and informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
  • Irie Tetsumi
    Department of Clinical Chemistry and informatics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
  • Kadowaki Daisuke
    Laboratory of Clinical Pharmaceutics, Faculty of Pharmaceutical Science, Sojo University, Kumamoto, Japan
  • Hirata Sumio
    Department of Clinical Pharmacology, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan I&H Co., Ltd., Ashiya, Japan

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Other Title
  • サルコペニア患者の腎機能予測における血清クレアチニン値0.6 mg/dLへのround upの妥当性評価
  • サルコペニア カンジャ ノ ジンキノウ ヨソク ニ オケル ケッセイ クレアチニンチ 0.6mg/dL エ ノ round up ノ ダトウセイ ヒョウカ

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<p>In Japan, renal function is estimated based on the serum creatinine (SCr) value, and specifically estimated creatinine clearance (eCCr) obtained with the Cockcroft–Gault (CG) equation and the estimated glomerular filtration rate (eGFRcr) for the Japanese population. However, renal function may be overestimated due to the decrease in SCr value associated with decreased muscle mass. To prevent this, SCr values are rounded up to 0.6 mg/dL for patients when less than 0.6 mg/dL. However, at present, there are few reports providing evidence that predictability has been improved by rounding up SCr values, and thus the scientific basis for rounding up is poor. In this study, we evaluated the validity of SCr values rounded up to 0.6 mg/dL. A retrospective analysis was performed on 11 patients aged 65 years or older with SCr values less than 0.6 mg/dL who were admitted to the Tamana Regional Medical Center in May-August 2017. Measured creatinine clearance (mCCr) was evaluated in 24-h urine samples, and modified glomerular filtration rate (mGFR) was calculated by multiplying mCCr by 0.715. Then, eCCr and eGFRcr using the SCr value measured by the enzymatic method, and eCCr (rounded-up) and eGFRcr (rounded-up) using the SCr value rounded up to 0.6 mg/dL, were compared with mCCr and modified GFR respectively. Correlation and regression analysis, Bland-Altman analysis, and the error index analysis revealed that eCCr (rounded-up) value tended to underestimate renal function more than eCCr value. The eGFRcr value markedly overestimated renal function, and the eGFRcr (rounded-up) value was also overestimated, although to a lesser extent. These results indicate the non-validity of rounding up SCr values to 0.6 mg/dL in both the eCCr and eGFRcr estimation formulas. Thus, unnecessarily rounding up the SCr values should be avoided in sarcopenia patients.</p>

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