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
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Improved renal survival in Japanese children with IgA nephropathy.
掲載誌名	正式名：Pediatric nephrology (Berlin, Germany) 略　 称：Pediatr Nephrol ISSNコード：0931041X/0931041X
掲載区分	国外
巻・号・頁	23(6),pp.905-12
著者・共著者	Nahoko Yata, Koichi Nakanishi, Yuko Shima, Hiroko Togawa, Mina Obana, Mayumi Sako, Kandai Nozu, Ryojiro Tanaka, Kazumoto Iijima, Norishige Yoshikawa
発行年月	2008/06
概要	Since the beginning of the 1990s, Japanese medical practitioners have extensively prescribed angiotensin-converting enzyme (ACE) inhibitors for children with mild IgA nephropathy (IgA-N) and steriods for those with severe IgA-N. We have performed a retrospective cohort study to clarify whether the long-term outcome has improved in Japanese children with IgA-N. Renal survival was defined as the time from onset to end-stage renal disease (ESRD). We divided the study period into two time periods based on the occurrence of the initial renal biopsy:1976-1989 and 1990-2004. Actuarial survivals were calculated by Kaplan-Meier method, and comparisons were made with the logrank test. The Cox proportional hazard model was used for multivariate analysis. Between 1976 and 2004, 500 children were diagnosed as having IgA-N in our hospitals. The actuarial renal survival from the time of apparent disease onset was 96.4% at 10 years, 84.5% at 15 years and 73.9% at 20 years. Renal survival in the 1990-2004 period was significantly better than that in 1976-1989 (p=0.008), and a marked improvement in renal survival in patients with severe IgA-N was also observed (p=0.0003). Multivariate analysis indicated that diagnosis year was a significant factor for ESRD-free survival independently of baseline characteristics. The results of this study show that there has been an improvement in terms of renal survival in Japanese children with IgA-N.
DOI	10.1007/s00467-007-0726-5
PMID	18224344