Naoki Nakagawa1, Naoyuki Hasebe2, Motoshi Hattori3, Michio Nagata4, Hitoshi Yokoyama5, Hiroshi Sato6, Hitoshi Sugiyama7, Akira Shimizu8, Yoshitaka Isaka9, Shoichi Maruyama10, Ichiei Narita11. 1. Division of Cardiology and Nephrology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan. naka-nao@asahikawa-med.ac.jp. 2. Division of Cardiology and Nephrology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan. 3. Department of Pediatric Nephrology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. 4. Department of Kidney and Vascular Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 5. Division of Nephrology, Kanazawa Medical University School of Medicine, Uchinada, Japan. 6. Clinical Pharmacology and Therapeutics, Tohoku University, Graduate School of Pharmaceutical Sciences, Sendai, Japan. 7. Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. 8. Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-ku, Tokyo, 113-8602, Japan. 9. Department of Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. 10. Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 11. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Abstract
BACKGROUND: The incidence and age distribution of membranoproliferative glomerulonephritis (MPGN) vary throughout the world by race and ethnicity. We sought to evaluate the clinical features, pathogenesis, and age distribution of MPGN among a large nationwide data from the Japan Renal Biopsy Registry (J-RBR). METHODS: A cross-sectional survey of 593 patients with MPGN (types I and III) registered in the J-RBR between 2007 and 2015 was conducted. Clinical parameters, and laboratory findings at diagnosis were compared between children (< 20 years), adults (20-64 years), and elderly patients (≥ 65 years). RESULTS: The median age of the patients was 59.0 years and mean proteinuria was 3.7 g/day. The rate of nephrotic syndrome was significantly higher in adults (40.4%) and elderly patients (54.0%) than in children (14.9%), whereas the rate of chronic glomerulonephritis was significantly higher in children (66.2%) than in adults (34.4%) and elderly patients (31.2%). According to the CGA risk classification, high-risk (red zone) cases accounted for 3.4% of children, 52.5% of adults and 84.1% of elderly patients with MPGN. As for pathogenesis, primary MPGN was most frequent (56.0%). Lupus nephritis was the most common disease among adult patients with secondary MPGN, whereas infectious disease was more common in elderly patients. Multiple regression analysis revealed that high systolic blood pressure and high proteinuria were independent factors associated with decreased estimated glomerular filtration rate (eGFR) in adults and elderly patients with MPGN. CONCLUSIONS: In Japan, adults and elderly patients with MPGN had a lower eGFR and severer proteinuria than children.
BACKGROUND: The incidence and age distribution of membranoproliferative glomerulonephritis (MPGN) vary throughout the world by race and ethnicity. We sought to evaluate the clinical features, pathogenesis, and age distribution of MPGN among a large nationwide data from the Japan Renal Biopsy Registry (J-RBR). METHODS: A cross-sectional survey of 593 patients with MPGN (types I and III) registered in the J-RBR between 2007 and 2015 was conducted. Clinical parameters, and laboratory findings at diagnosis were compared between children (< 20 years), adults (20-64 years), and elderly patients (≥ 65 years). RESULTS: The median age of the patients was 59.0 years and mean proteinuria was 3.7 g/day. The rate of nephrotic syndrome was significantly higher in adults (40.4%) and elderly patients (54.0%) than in children (14.9%), whereas the rate of chronic glomerulonephritis was significantly higher in children (66.2%) than in adults (34.4%) and elderly patients (31.2%). According to the CGA risk classification, high-risk (red zone) cases accounted for 3.4% of children, 52.5% of adults and 84.1% of elderly patients with MPGN. As for pathogenesis, primary MPGN was most frequent (56.0%). Lupus nephritis was the most common disease among adult patients with secondary MPGN, whereas infectious disease was more common in elderly patients. Multiple regression analysis revealed that high systolic blood pressure and high proteinuria were independent factors associated with decreased estimated glomerular filtration rate (eGFR) in adults and elderly patients with MPGN. CONCLUSIONS: In Japan, adults and elderly patients with MPGN had a lower eGFR and severer proteinuria than children.
Entities:
Keywords:
Age distribution; Membranoproliferative glomerulonephritis; Registry; Renal pathology
Authors: Sanjeev Sethi; Mark Haas; Glen S Markowitz; Vivette D D'Agati; Helmut G Rennke; J Charles Jennette; Ingeborg M Bajema; Charles E Alpers; Anthony Chang; Lynn D Cornell; Fernando G Cosio; Agnes B Fogo; Richard J Glassock; Sundaram Hariharan; Neeraja Kambham; Donna J Lager; Nelson Leung; Michael Mengel; Karl A Nath; Ian S Roberts; Brad H Rovin; Surya V Seshan; Richard J H Smith; Patrick D Walker; Christopher G Winearls; Gerald B Appel; Mariam P Alexander; Daniel C Cattran; Carmen Avila Casado; H Terence Cook; An S De Vriese; Jai Radhakrishnan; Lorraine C Racusen; Pierre Ronco; Fernando C Fervenza Journal: J Am Soc Nephrol Date: 2015-11-13 Impact factor: 10.121
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