Maki Urushihara1, Hiroshi Sato2, Akira Shimizu3, Hitoshi Sugiyama4, Hitoshi Yokoyama5, Hiroshi Hataya6, Kentaro Matsuoka7, Takayuki Okamoto8, Daisuke Ogino9, Kenichiro Miura10, Riku Hamada6, Satoshi Hibino11, Yuko Shima12, Tomohiko Yamamura13, Koichi Kitamoto14, Masayuki Ishihara15, Takao Konomoto16, Motoshi Hattori10. 1. Department of Pediatrics, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto-cho 3-18-15, Tokushima, Tokushima, 770-8503, Japan. urushihara@tokushima-u.ac.jp. 2. Deparment of Internal Medicine, Sendai Hospital of East Japan Railway Company, Sendai, Japan. 3. Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan. 4. Department of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. 5. Department of Nephrology, Kanazawa Medical University, Uchinada, Japan. 6. Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 7. Department of Pathology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 8. Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. 9. Department of Pediatrics, Yamagata University School of Medicine, Yamagata, Japan. 10. Depatment of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan. 11. Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Obu, Japan. 12. Department of Pediatrics, Wakayama Medical University, Wakayama City, Wakayama, Japan. 13. Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan. 14. Division of Pediatrics and Perinatology, Faculty of Medicine, Tottori University, Yonago, Japan. 15. Department of Pediatrics, Kochi Medical School, Kochi University, Kochi, Japan. 16. Division of Pediatrics, Department of Reproductive and Developmental Medicine Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Abstract
BACKGROUND: Only a few studies have investigated epidemiological and clinicopathological information regarding pediatric and adolescent and young adult (AYA) patients with renal disease. The purpose of this study was to clarify the differences and relationship of clinicopathological findings between pediatric and AYA patients using the Japan Renal Biopsy Registry (J-RBR). METHODS: This cross-sectional study analyzed data from patients registered in the J-RBR between 2007 and 2017. Clinicopathological findings at diagnosis were analyzed for 3,463 pediatric (age < 15 years) and 6,532 AYA (age 15-30 years) patients. RESULTS: Although chronic nephritic syndrome was the most common clinical diagnosis at age > 5 years, nephrotic syndrome was the most frequent diagnosis at age < 4 years. The most common pathological diagnosis as classified by pathogenesis in pediatric patients was primary glomerular disease (except IgA nephropathy), whereas IgA nephropathy was increased in AYA patients. Mesangial proliferative glomerulonephritis was the most common pathological diagnosis as classified by histopathology in both pediatric and AYA patients. Minor glomerular abnormalities were the most frequent histopathologic diagnoses of nephrotic syndrome in childhood, but their frequency decreased with age. CONCLUSION: To the best of our knowledge, this is the first report of clinicopathological features of pediatric and AYA patients in a large nationwide registry of renal biopsy. There were differences of clinical, pathological and histopathologic findings between pediatric and AYA patients.
BACKGROUND: Only a few studies have investigated epidemiological and clinicopathological information regarding pediatric and adolescent and young adult (AYA) patients with renal disease. The purpose of this study was to clarify the differences and relationship of clinicopathological findings between pediatric and AYA patients using the Japan Renal Biopsy Registry (J-RBR). METHODS: This cross-sectional study analyzed data from patients registered in the J-RBR between 2007 and 2017. Clinicopathological findings at diagnosis were analyzed for 3,463 pediatric (age < 15 years) and 6,532 AYA (age 15-30 years) patients. RESULTS: Although chronic nephritic syndrome was the most common clinical diagnosis at age > 5 years, nephrotic syndrome was the most frequent diagnosis at age < 4 years. The most common pathological diagnosis as classified by pathogenesis in pediatric patients was primary glomerular disease (except IgA nephropathy), whereas IgA nephropathy was increased in AYA patients. Mesangial proliferative glomerulonephritis was the most common pathological diagnosis as classified by histopathology in both pediatric and AYA patients. Minor glomerular abnormalities were the most frequent histopathologic diagnoses of nephrotic syndrome in childhood, but their frequency decreased with age. CONCLUSION: To the best of our knowledge, this is the first report of clinicopathological features of pediatric and AYA patients in a large nationwide registry of renal biopsy. There were differences of clinical, pathological and histopathologic findings between pediatric and AYA patients.
Authors: Alan R Watson; Paul N Harden; Maria E Ferris; Peter G Kerr; John D Mahan; Maher Fouad Ramzy Journal: Kidney Int Date: 2011-08-10 Impact factor: 10.612