Serum Creatinine Values to 2nd Decimal Place are Mandatory for Calculation of Estimated Glomerular Filtration Rate (eGFR) in Chronic Kidney Disease (CKD) Staging

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  • 推算糸球体濾過量の算出には小数点以下2桁の血清クレアチニン値が重要
  • スイサン シキュウタイ ロカリョウ ノ サンシュツ ニワ ショウスウテン イカ 2ケタ ノ ケッセイ クレアチニンチ ガ ジュウヨウ

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Objective: In calculating the estimated glomerular filtration rate (eGFR)，we compared serum creatinine values to the 2nd decimal place (Cr2) with those to the 1st decimal place (Cr1) after rounding off. <br>Methods: The criteria for CKD staging and equation for calculating GFR used were those published by the Japan Society of Kidney Disease. EGFRs calculated using Cr2 and Cr1 were designated eGFR(Cr2) and eGFR(Cr1), respectively. In this study, creatinine levels of 1,102 people (699 men and 403 women) were measured by the enzyme method and analyzed. <br>Results : No subjects were classified as stage 4(eGFR: 15-29) or 5(eGFR: less than 15). An eGFR(Cr2) having 1 to 4 at the second decimal place was lower than eGFR(Cr1), whereas an eGFR(Cr2) having 5 to 9 at the 2nd decimal place was higher than eGFR(Cr1). Numbers of subjects classified as CKD stages using eGFR(Cr2) and eGFR(Cr1) were indicated as eGFR(Cr2)/eGFR(Cr1). According to this system, in men, 28/30 subjects were stage 3(eGFR: 30-59), 427/442 were stage 2(eGFR; 60-89) and 244/227 were stage 1(eGFR; over 90). In women, 9/12 were stage 3, 207/202 were stage 2 and 187/189 stage 1. Therefore, the stagings determined by eGFR(Cr1) were different from those by eGFR(Cr2) and not correct. Eleven of 50 men with a Cr1 of 1.0mg/dL were classified as stage 3 but none of 51 women with a Cr1 of 0.7mg/dL was classified as stage 3, indicating that it is impossible to determine CKD stagings by Cr1 alone.<br>Conclusion : Since eGFR(Cr1) was different from and less reliable than eGFR(Cr2), Cr2 and eGFR(Cr2) should be used in health care center reports regarding healthy people and those with moderate hypofunction of the kidney.

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