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タナカ リョウジロウ
Ryojiro Tanaka
田中 亮二郎 所属 川崎医科大学 医学部 臨床医学 小児科学 職種 特任教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Renal biopsy criterion in children with asymptomatic constant isolated proteinuria. |
| 掲載誌名 | 正式名：Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 略 称：Nephrol Dial Transplant ISSNコード：14602385/09310509 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 27(8),pp.3186-90 |
| 著者・共著者 | Taketsugu Hama, Koichi Nakanishi, Yuko Shima, Hironobu Mukaiyama, Hiroko Togawa, Ryojiro Tanaka, Kiyoshi Hamahira, Hiroshi Kaito, Kazumoto Iijima, Norishige Yoshikawa |
| 発行年月 | 2012/08 |
| 概要 | BACKGROUND:The criterion of a renal biopsy in children with asymptomatic persistent isolated proteinuria is controversial.METHODS:To determine an adequate renal biopsy criterion in children with asymptomatic constant isolated proteinuria, the optimal cutoff maximum urinary protein/creatinine ratio (uP/Cr) to separate minor glomerular abnormalities (MGA) and other significant glomerular changes was obtained by receiver operating characteristic analysis in 44 children with asymptomatic constant isolated proteinuria (uP/Cr ≥ 0.2 g/g) screened from 1167 patients who underwent a renal biopsy between September 2000 and April 2010. Patients were divided into two groups according to the cutoff value to verify its validity.RESULTS:The optimal uP/Cr was 0.5 g/g. In Group 1 (uP/Cr <0.5 g/g, n = 15), only one patient (6.7%) showed focal segmental glomerulosclerosis (FSGS) and the other 14 patients (93.3%) had MGA. In Group 2 (uP/Cr ≥ 0.5 g/g at least once before biopsy, n = 29), 5 patients showed FSGS and 7 patients had nephritis such as IgA nephropathy (41.4%, n = 12) and the other 17 patients (58.6%) showed MGA. These findings indicated that the ratio of non-MGA/MGA was significantly higher in Group 2 than that in Group 1 (P = 0.016) and that if renal biopsies were performed with a criterion of a maximum uP/Cr ≥ 0.5 g/g (criterion for Group 2), renal biopsies could be avoided in 45.2% of patients with MGA. One patient with FSGS in Group 1 showed proteinuria with uP/Cr ≥ 0.5 g/g in the clinical course.CONCLUSIONS:An adequate renal biopsy criterion in children with asymptomatic constant isolated proteinuria is uP/Cr ≥ 0.5 g/g. |
| DOI | 10.1093/ndt/gfr750 |
| PMID | 22231035 |