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	Progression to end-stage kidney disease in Japanese children with chronic kidney disease: results of a nationwide prospective cohort study.
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	29(4),pp.878-84
著者・共著者	Kenji Ishikura, Osamu Uemura, Yuko Hamasaki, Shuichi Ito, Naohiro Wada, Motoshi Hattori, Yasuo Ohashi, Ryojiro Tanaka, Koichi Nakanishi, Tetsuji Kaneko, Masataka Honda, ,
発行年月	2014/04
概要	BACKGROUND:The risk of progressing to end-stage kidney disease (ESKD) and factors associated with progression in children with chronic kidney disease (CKD) are unclear, especially in Asian children.METHODS:We started a nationwide, prospective cohort study of 447 Japanese children with pre-dialysis CKD in 2010, with follow-up in 2011. Progression to ESKD was analyzed by Kaplan-Meier analysis according to CKD stage. Cox regression analysis was used to identify risk factors for progression.RESULTS:Data were analyzed for 429/447 children. Five patients died, of which four died before progression to ESKD. Fifty-two patients progressed to ESKD (median follow-up 1.49 years), including 9/315 patients with stage 3 CKD, 29/107 with Stage 4 CKD and 14/25 with Stage 5 CKD. One-year renal survival rates were 98.3, 80.0 and 40.9%, for Stages 3, 4 and 5 CKD, respectively. Risk factors for progression to ESKD included CKD stage [versus Stage 3; Stage 4: hazard ratio (HR) 11.12, 95% confidence interval (CI) 4.22-29.28, P < 0.001; Stage 5: HR 26.95, 95% CI 7.71-94.17, P < 0.001], heavy proteinuria (>2.0 g/g urine creatinine; HR 7.56, 95% CI 3.22-17.77, P < 0.001) and age ( < 2 years: HR 9.06; 95% CI 2.29-35.84, P = 0.002; after starting puberty: HR 4.88; 95% CI 1.85-12.85, P = 0.001).CONCLUSIONS:In this cohort, 12.5% of children with pre-dialysis CKD progressed to ESKD with a median-follow-up of 1.49 years. Children with advanced (Stage 4/5) CKD were particularly likely to progress. To our knowledge, this is the first, nationwide, prospective cohort study of children with pre-dialysis CKD in Asia.
DOI	10.1093/ndt/gfu012
PMID	24516225