事業案内

小児CKD対策委員会

会務内容

本委員会は、本邦の小児慢性腎臓病(小児CKD)の診療の水準を向上させることを第一の目的としております。さらに、小児CKD関連の様々な研究の基盤を整備し、かつ学会主導の臨床研究を行い国際的に発信していくことも目指しています。
CKDは歴史的に成人領域から発展した概念です。しかし小児のCKDでは原疾患が成人のCKDと大きく異なる(生活習慣病が多い成人と異なりCAKUTが多い)、成長、発達など小児特有の問題がある、罹病期間が著しく長いことなどから、成人のCKDとは全く異なる管理が求められます。従って成人とは独立した「小児CKD」としてとらえるべき病態で、小児独自のエビデンスも必要です。小児CKD対策員会の存在意義もまさにここにあります。
2006年当時は小児CKD患者の実態を把握するための腎機能評価のdeviceがなく、10年間をかけてイヌリンクリアランス法の標準化、腎機能マーカーの基準値の設定やGFR推算式(eGFR)の作成を日本人小児について進め日本人小児の腎機能評価を可能にしました。また並行して厚生労働省科学研究で行われる小児CKD疫学調査や乳幼児腎臓病検診(3歳児検尿)の質の向上に向けての活動に協力しました。また、作成した情報の広報啓発のために、eGFR計算アプリケーションの作成を行い、「小児慢性腎臓病診断時の腎機能評価の手引き」の作成に協力してきました。
今後は腎機能評価だけでなく、日本人小児の血圧や腎サイズの基準値作りも重要なテーマと考えています。また、イヌリンクリアランスのためのイヌリードの小児適応取得のための治験、前述の厚生労働科学研究など、今後の小児CKDの診療や研究を進めるうえで必要な情報作りを進めていきます。皆さんのご協力をお願いします。

委員会に関連する研究報告

日本人小児の腎機能評価に関する報告

  • Uemura O, Honda M, Matsuyama T, et al: Age, gender, and body length effects on reference serum creatinine levels determined by an enzymatic method in Japanese children: a multicenter study. Clin Exp Nephrol 2011; 15:694-9.
  • Uemura O, Honda M, Matsuyama T, et al: Is the new Schwartz equation derived from serum creatinine and body length usable for evaluation of renal function in Japanese children? Eur J Pediatr 2012; 171:1401-4.
  • Yata N, Uemura O, Honda M, et al: Reference ranges for serum cystatin C measurements in Japanese children by using 4 automated assays. Clin Exp Nephrol 2013; 17: 872-6.
  • Ikezumi Y, Honda M, Uemura O, et al: Establishment of a normal reference value for serum β2 microglobulin in Japanese children: Reevaluation of its clinical usefulness. Clin Exp Nephrol 2013; 17:99-105.
  • Nagai T, Uemura O, Ishikura K, et al: Creatinine-based equations to estimate glomerular filtration rate in Japanese children aged between 2 and 11 years old with chronic kidney disease. Clin Exp Nephrol 2013; 17: 877-81.
  • Uemura O, Nagai T, Ishikura K, et al: Creatinine-based equation to estimate the glomerular filtration rate in Japanese children and adolescents with chronic kidney disease. Clin Exp Nephrol. Clin Exp Nephrol 2014; 18: 626-33.
  • Uemura O, Ishikura K, Gotoh Y, Honda M. Creatinine-based estimated glomerular filtration rate for children younger than 2 years. Clin Exp Nephrol. 2018; 22: 483-4.
  • Uemura O, Nagai T, Ishikura K, et al: Cystatin C-based equation to estimate glomerular filtration rate in Japanese children and adolescents. Clin Exp Nephrol 2014; 18: 718-25.-
  • Ikezumi Y, Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Fujita N, Akioka Y, Kaneko T, Iijima K, Honda M. Beta-2 microglobulin-based equation for estimating glomerular filtration rates in Japanese children and adolescents. Clin Exp Nephrol 2015; 19: 450-7.
  • Uemura O, Nagai T, Ishikura K, Ito S, Hataya H, Gotoh Y, Fujita N, Akioka Y, Kaneko T, Honda M. Reference glomerular filtration rate levels in Japanese children: using the creatinine and cystatin C based estimated glomerular filtration rate. Clin Exp Nephrol 2015; 19: 683-7.
  • Uemura O, Nagai T, Ishikura K, Ito S, Honda M. Mean and standard deviation of reference glomerular filtration rate values in Japanese children. Clin Exp Nephrol. 2016; 20: 317-8.
  • Uemura O, Nagai T, Yamakawa S, Kaneko T, Hibi Y, Yamasaki Y, Yamamoto M, Nakano M, Iwata N, Hibino S. Assessment of kidney function in children by enzymatic determination of 2- or 24-h creatinine clearance: comparison with inulin clearance. Clin Exp Nephrol. 2016; 20: 462-8.
  • Gotoh Y, Uemura O, Ishikura K, Sakai T, Hamasaki Y, Araki Y, Hamda R, Honda M; Pediatric CKD Study Group in Japan in conjunction with the Committee of Measures for Pediatric CKD of the Japanese Society of Pediatric Nephrology. Validation of estimated glomerular filtration rate equations for Japanese children. Clin Exp Nephrol. 2018 Jan 25. [Epub ahead of print]
  • Uemura O, Yokoyama H, Ishikura K, Gotoh Y, Sato H, Sugiyama H, Honda M, Matsuo S. Performance in adolescents of the two Japanese serum creatinine based estimated glomerular filtration rate equations, for adults and paediatric patients: A study of the Japan Renal Biopsy Registry and Japan Kidney Disease Registry from 2007 to 2013. Nephrology. 2017; 22: 494-497.
  • Nakano M, Uemura O, Honda M, Ito T, Nakajima Y, Saitoh S. Development of tandem mass spectrometry-based creatinine measurement using dried blood spot for newborn mass screening. Pediatr Res. 2017; 82: 237-243.
  • Uemura O, Iwata N, Nagai T, Yamakawa S, Hibino S, Yamamoto M, Nakano M, Tanaka K. Influence of thyroid function on glomerular filtration rate and other estimates of kidney function in two pediatric patients. CEN Case Rep. 2018; 7: 169-173.

小児CKD疫学調査に関する報告

  • Ishikura K, Uemura O, Ito S, Wada N, Hattori M, Ohashi Y, Hamasaki Y, Tanaka R, Nakanishi K, Kaneko T, Honda M. Pre-dialysis chronic kidney disease in children: results of a nationwide survey in Japan. Nephrol Dial Transplant. 2013; 28: 2345-55.
  • Ishikura K, Uemura O, Hamasaki Y, Ito S, Wada N, Hattori M, et al. Progression to end-stage kidney disease in Japanese children with chronic kidney disease: results of a nationwide prospective cohort study. Nephrol Dial Transplant 2014; 29: 878-884.
  • Yanagihara T, Hamada R, Ishikura K, Uemura O, Matsuyama T, Takahashi S, Honda M. Urinary screening and urinary abnormalities in 3-year-old children in Japan. Pediatr Int. 2015; 57: 354-8.
  • Hamasaki Y, Ishikura K, Uemura O, Ito S, Wada N, Hattori M, Ohashi Y, Tanaka R, Nakanishi K, Kaneko T, Honda M. Growth impairment in children with pre-dialysis chronic kidney disease in Japan. Clin Exp Nephrol. 2015; 19: 1142-8.
  • Ishikura K, Uemura O, Hamasaki Y, Nakai H, Ito S, Harada R, Hattori M, Ohashi Y, Tanaka R, Nakanishi K, Kaneko T, Iijima K, Honda M; Pediatric CKD Study Group in Japan in conjunction with the Committee of Measures for Pediatric CKD of the Japanese Society for Pediatric Nephrology. Insignificant impact of VUR on the progression of CKD in children with CAKUT. Pediatr Nephrol. 2016; 31: 105-12.
  • Hirano D, Ishikura K, Uemura O, Ito S, Wada N, Hattori M, Ohashi Y, Hamasaki Y, Tanaka R, Nakanishi K, Kaneko T, Honda M. Association between low birth weight and childhood-onset chronic kidney disease in Japan: a combined analysis of a nationwide survey for paediatric chronic kidney disease and the National Vital Statistics Report. Nephrol Dial Transplant. 2016; 31: 1895-1900.

このページのトップへ戻る