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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 | Factors related to recurrence of proteinuria in childhood IgA nephropathy. |
| 掲載誌名 | 正式名：Pediatric nephrology (Berlin, Germany) 略 称：Pediatr Nephrol ISSNコード：1432198X/0931041X |
| 掲載区分 | 国外 |
| 巻・号・頁 | 39(2),pp.463-471 |
| 著者・共著者 | Yuko Shima, Hironobu Mukaiyama, Yu Tanaka, Wataru Shimabukuro, Kandai Nozu, Hiroshi Kaito, Ryojiro Tanaka, Mayumi Sako, Kazumoto Iijima, Daisuke Tokuhara, Norishige Yoshikawa, Koichi Nakanishi |
| 発行年月 | 2024/02 |
| 概要 | BACKGROUND:Proteinuria remission is the most significant predictive factor for kidney outcome in childhood IgA nephropathy (c-IgAN). Even if proteinuria remission can be obtained, some patients have recurrence of proteinuria in the long-term.METHODS:This is a retrospective analysis of 312 cases of proteinuria remission among 538 consecutive children with biopsy-proven IgAN from 1976 to 2013. To elucidate the incidence and factors related to recurrence of proteinuria in c-IgAN, we compare clinical and pathological findings between patients with and without recurrence of proteinuria.RESULTS:Among 312 patients with remission of proteinuria, 91 (29.2%) had recurrence of proteinuria within the observation period (median 8 years). Using a multivariate Cox regression analysis, significant factors associated with recurrence of proteinuria were onset age (HR 1.13 [95%CI: 1.05-1.22], P = 0.002) and presence of hematuria after proteinuria remission (HR 2.11 [95%CI: 1.30-3.45], P = 0.003). The Kaplan-Meier analysis showed significant differences in CKD G3a-G5-free survival between the patients with no-recurrence of proteinuria, recurrence of proteinuria and non-proteinuria remission (P < 0.0001, log-rank test). Kidney survival was 100% in no-recurrence of proteinuria, 92.2% in recurrence of proteinuria, and 65.6% in non-proteinuria remission at 15 years. Cox analyses adjusted by proteinuria remission showed that recurrence of proteinuria (HR 03.10e9 [95%CI: NA], P = 0.003) was a significant factor associated with progression to CKD G3a-G5 in all patients with c-IgAN.CONCLUSIONS:Approximately 30% of patients with proteinuria remission had recurrence of proteinuria regardless of treatment. Both remission and recurrence of proteinuria are significant prognostic factors for kidney outcome. A higher resolution version of the Graphical abstract is available as Supplementary information. |
| DOI | 10.1007/s00467-023-06116-4 |
| PMID | 37594578 |