Epidemiological analysis on chronic kidney disease in Asian population after standardization of creatinine measurement

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For Chronic Kidney Disease(CKD) diagnosis and staging, is essential to evaluate kidney function by glomerular filtration rate(GFR). Estimated GFR could be calculated by serum creatinine(Cr), age and gender, therefore it is important to evaluate GFR by reliable Cr values. In this international collaborative study in Korea, Taiwan, Thailand and Japan, we analyzed Cr values measured in collaborative centers by Jaffe method and standardized Cr values in a central laboratory in Japan. Cr values in Taiwan were almost identical to Japanese standardized one, while those in Korea exhibited approximately 0. 2mg/dL higher values, which revealed a significance of standardization of Cr measurement methods.There is a controversy in ethnic coefficient for MDRD equation among Asians, regardless of similar genetics, food and lifestyle compared to Caucasian. In this study, we measured GFR by inulin clearance with an uniform protocol in 200 Korean, 200 Taiwanese and 60 Thai patients, and compare accuracies of Japanese GFR and MDRD equations in individual ethnics. Japanese GFR equations revealed better accuracy in Korean but not in Taiwanese. Cr excretion rate, a marker of body muscle mass, was greater in Taiwanese compared to Japanese and Korean, which suggest that different body muscle mass plays a major role in different ethnic coefficient.Based on standardized Cr values and reliable Japanese GFR equation, we conducted CKD prevalence analysis among approximately 100, 000 health-check subjects in Aichi prefecture. Positive rates of proteinuria were greater in Aichi than in the national survey, in both male and female, and in all age groups. Prevalence of low GFR less than 60 mL/min/1. 73m2 was 8. 6% in Aichi prefecture, which was smaller than 10. 6% in the national survey, provably due to different vital statics in Aichi prefecture.