Asian Collaborative Study for Creation of GFR Estimation Equation (ACOS-CG-FREE)

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Glomerular filtration rate (GFR) Project by Japanease Society of Nephrology was carried among 80 collaborating centers all over Japan and new Japanese GFR equations were developed in 413 participants and validated in 350 participants. In our study, GFR was evaluated in 95 Japanese cases.Protocol of inulin clearance (Cin) was simplified in this study. In the standard method, GFR is evaluated by 3 sets of Cin for 30 minutes, which is not practical in clinical use. GFR evaluated with 2 consecutive Cin for 30 minutes was compared to those with 3 consecutive one in 737 cases. GFR by 2 consecutive Cin showed high correlation coefficients against GFR by 3 Cin tests (r=0.988). Root mean square error (RMSE) was 5.3 ml/min per 1.73 m^2. Therefore, GFR was evaluated by simplified Cin protocol with 2 consecutive Cin tests in this study.Doctor driven clinical trials of Cin tests were conducted in Korea and Taiwan. Using simplified Cin protocol, GFR was evaluated in 113 Korean and 200 Taiwanese cases and Japanse GFR equation was validated. All samples were assayed in a central laboratory in Japan. No severe adverse event by Cin test was reported. Accuracy within 30% of measured GFR was 74% for Japanese equation, which is greater than that of MDRD or Cockroft-Gault equation.In conclusion, Japanese GFR equation are more accurate for the Korean and Taiwanese population than the previously reported equations.