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 Long-term outcome of childhood IgA nephropathy with minimal proteinuria.
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 30(12),pp.2121-7
著者・共著者 Asumi Higa, Yuko Shima, Taketsugu Hama, Masashi Sato, Hironobu Mukaiyama, Hiroko Togawa, Ryojiro Tanaka, Kandai Nozu, Mayumi Sako, Kazumoto Iijima, Koichi Nakanishi, Norishige Yoshikawa
発行年月 2015/12
概要 BACKGROUND:Some patients with childhood immunoglobulin A nephropathy (IgAN) progress to end-stage renal disease within 20 years, while others achieve spontaneous remission even without medication. Prognosis of IgAN with minimal proteinuria (MP-IgAN, <0.5 g/day/1.73 m(2)) at diagnosis seems to be generally good. However, the long-term outcome for patients with childhood MP-IgAN has not yet been determined.METHODS:We retrospectively analyzed 385 children newly diagnosed with biopsy-proven IgAN between June 1976 and July 2009 whose renal biopsy specimens could be evaluated by the Oxford classification criteria. Of these 385 children with IgAN, 106 (27.5%) were diagnosed with MP-IgAN. We compared clinical and pathological findings between the 106 patients with MP-IgAN and the remaining 279 patients to elucidate the characteristics of MP-IgAN in children.RESULTS:Patients with MP-IgAN were identified through a school screening program (73.6%) or upon presentation with gross hematuria (26.4%). Patients with MP-IgAN had significantly milder pathological symptoms than those with IgAN. The most frequently used therapeutic regimes were angiotensin converting enzyme inhibitors (30.2%) and no therapy (36.8%). None of the patients with MP-IgAN reached stage III chronic kidney disease within 15 years after onset. Four patients with MP-IgAN (3.8 %) received immunosuppressive therapy during the course of the disease.CONCLUSION:Our results indicate that the outcome of patients with a diagnosis of childhood MP-IgAN is good, but that careful long-term observation is required.
DOI 10.1007/s00467-015-3176-5
PMID 26238276