2023 Fiscal Year Final Research Report

Renal plasma flow (RPF) and accurate GFR equations utilizing metabolomics analysis

Research Project

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Project/Area Number	20H03575
Research Category	Grant-in-Aid for Scientific Research (B)
Allocation Type	Single-year Grants
Section	一般
Review Section	Basic Section 52010:General internal medicine-related
Research Institution	Nagoya University
Principal Investigator	Yasuda Yoshinari 名古屋大学, 医学系研究科, 特任准教授 (60432259)
Co-Investigator(Kenkyū-buntansha)	平山明由慶應義塾大学, 政策・メディア研究科(藤沢), 准教授 (00572405) 丸山彰一名古屋大学, 医学系研究科, 教授 (10362253) 加藤規利名古屋大学, 医学部附属病院, 講師 (90716052)
Project Period (FY)	2020-04-01 – 2023-03-31
Keywords	糸球体濾過量（GFR) / 腎血漿隆昌（RPF) / メタボローム解析 / サルコペニア / シスタチンC
Outline of Final Research Achievements	In this study, GFR and RPF were measured, and novel RPF equation was created by using metabolome analysis, which was validated in Japanese patients treated by SGLT2 inhibitor. Among patients with small muscle mass, new GFR equation using psoas muscle index (PMI) in CT images was created and validated in patients with spinal cord injury or spinal cord injury or anorexia nervosa. CKD-EPIcr 2021 equation without race coefficient has been reported, however we revealed that the equation overestimates GFR among Japanese patients and Japanese coefficient of 0.908 was needed. In international collaboration study measuring GFR by inulin clearance, we clarified that CKD-EPIcys2021 could accurately estimate GFR in Japanese and Indians, although they have smaller body muscle mass compared with Caucasians or African Americans.
Free Research Field	腎臓内科学
Academic Significance and Societal Importance of the Research Achievements	糸球体高血圧の評価には糸球体濾過量（GFR）に加えて腎血漿流量（RPF）を測定する必要があるが、ほとんどの腎専門施設でも検査が出来ず、RPF推算式は全く存在しなかったが、メタボローム解析により世界に先駆けてRPF推算式を作成した。血清クレアチニン（Cr）に基づくGFR推算式は筋肉量が標準と大きく異なる場合は適用できないが、CT画像の腸腰筋よりPMIを測定することで筋肉量が減少した患者における腎機能評価を可能とした。人種係数を用いないCKD-EPIcr式を日本人で適用する係数を作成し、ベジタリアンを含むインド人と日本人でもCKD-EPIcysは正確に腎機能評価できることを明らかにした。