A histologic classification of IgA nephropathy for predicting long-term prognosis: Emphasis on end-stage renal disease

Tetsuya Kawamura, Kensuke Joh, Hideo Okonogi, Kentaro Koike, Yasunori Utsunomiya, Yoichi Miyazaki, Masato Matsushima, Mitsuhiro Yoshimura, Satoshi Horikoshi, Yusuke Suzuki, Akira Furusu, Takashi Yasuda, Sayuri Shirai, Takanori Shibata, Masayuki Endoh, Motoshi Hattori, Yuko Akioka, Ritsuko Katafuchi, Akinori Hashiguchi, Kenjiro KimuraSeiichi Matsuo, Yasuhiko Tomino

研究成果: Article

58 引用 (Scopus)

抄録

A multicenter case-control study on IgA nephropathy (IgAN) was conducted to develop an evidence-based clinicopathologic classification of IgAN for predicting long-term renal outcome. Methods: Two hundred and eighty-seven patients including those with isolated hematuria or very mild proteinuria were enrolled. During a median follow-up of 9.3 years after biopsy, 49 patients (17%) progressed to end stage renal disease (ESRD). The associations between pathological variables and the need for chronic dialysis was examined by multivariate logistic regression analysis separately in patients who required dialysis earlier than 5 years (Early Progressors) and those who required dialysis within 5 to 10 years (Late Progressors) after biopsy. Results: Independent pathological variables predicting progression to ESRD were global sclerosis, segmental sclerosis and fibrous crescents for Early Progressors, and global sclerosis and cellular/fibrocellular crescents for Late Progressors. Four histological grades, HG 1, HG 2, HG 3 and HG 4, were established corresponding to <25%, 25-49%, 50-74% and ≥75% of glomeruli exhibiting cellular or fibrocellular crescents, global sclerosis, segmental sclerosis or fibrous crescents. Eleven (7%) patients in HG 1, 12 (16%) in HG 2, 13 (31%) in HG 3 and 13 (68%) in HG 4 progressed to ESRD. Multivariate logistic analysis revealed that the risk of progression to ESRD was significantly higher in HG 2, 3 and 4 than in HG 1 (odds ratio, 2.4, 5.7 and 27.6 vs. 1.0). Conclusions: Our evidence-based histologic classification can identify the magnitude of the risk of progression to ESRD and is useful for predicting longterm renal outcome in IgAN.

元の言語English
ページ(範囲)350-357
ページ数8
ジャーナルJournal of Nephrology
26
発行部数2
DOI
出版物ステータスPublished - 2013

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Sclerosis
Immunoglobulin A
Chronic Kidney Failure
Dialysis
Kidney
Biopsy
Hematuria
Proteinuria
Case-Control Studies
Multivariate Analysis
Logistic Models
Odds Ratio
Regression Analysis

ASJC Scopus subject areas

  • Nephrology

これを引用

Kawamura, T., Joh, K., Okonogi, H., Koike, K., Utsunomiya, Y., Miyazaki, Y., ... Tomino, Y. (2013). A histologic classification of IgA nephropathy for predicting long-term prognosis: Emphasis on end-stage renal disease. Journal of Nephrology, 26(2), 350-357. https://doi.org/10.5301/jn.5000151

A histologic classification of IgA nephropathy for predicting long-term prognosis : Emphasis on end-stage renal disease. / Kawamura, Tetsuya; Joh, Kensuke; Okonogi, Hideo; Koike, Kentaro; Utsunomiya, Yasunori; Miyazaki, Yoichi; Matsushima, Masato; Yoshimura, Mitsuhiro; Horikoshi, Satoshi; Suzuki, Yusuke; Furusu, Akira; Yasuda, Takashi; Shirai, Sayuri; Shibata, Takanori; Endoh, Masayuki; Hattori, Motoshi; Akioka, Yuko; Katafuchi, Ritsuko; Hashiguchi, Akinori; Kimura, Kenjiro; Matsuo, Seiichi; Tomino, Yasuhiko.

:: Journal of Nephrology, 巻 26, 番号 2, 2013, p. 350-357.

研究成果: Article

Kawamura, T, Joh, K, Okonogi, H, Koike, K, Utsunomiya, Y, Miyazaki, Y, Matsushima, M, Yoshimura, M, Horikoshi, S, Suzuki, Y, Furusu, A, Yasuda, T, Shirai, S, Shibata, T, Endoh, M, Hattori, M, Akioka, Y, Katafuchi, R, Hashiguchi, A, Kimura, K, Matsuo, S & Tomino, Y 2013, 'A histologic classification of IgA nephropathy for predicting long-term prognosis: Emphasis on end-stage renal disease', Journal of Nephrology, 巻. 26, 番号 2, pp. 350-357. https://doi.org/10.5301/jn.5000151
Kawamura, Tetsuya ; Joh, Kensuke ; Okonogi, Hideo ; Koike, Kentaro ; Utsunomiya, Yasunori ; Miyazaki, Yoichi ; Matsushima, Masato ; Yoshimura, Mitsuhiro ; Horikoshi, Satoshi ; Suzuki, Yusuke ; Furusu, Akira ; Yasuda, Takashi ; Shirai, Sayuri ; Shibata, Takanori ; Endoh, Masayuki ; Hattori, Motoshi ; Akioka, Yuko ; Katafuchi, Ritsuko ; Hashiguchi, Akinori ; Kimura, Kenjiro ; Matsuo, Seiichi ; Tomino, Yasuhiko. / A histologic classification of IgA nephropathy for predicting long-term prognosis : Emphasis on end-stage renal disease. :: Journal of Nephrology. 2013 ; 巻 26, 番号 2. pp. 350-357.
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title = "A histologic classification of IgA nephropathy for predicting long-term prognosis: Emphasis on end-stage renal disease",
abstract = "A multicenter case-control study on IgA nephropathy (IgAN) was conducted to develop an evidence-based clinicopathologic classification of IgAN for predicting long-term renal outcome. Methods: Two hundred and eighty-seven patients including those with isolated hematuria or very mild proteinuria were enrolled. During a median follow-up of 9.3 years after biopsy, 49 patients (17{\%}) progressed to end stage renal disease (ESRD). The associations between pathological variables and the need for chronic dialysis was examined by multivariate logistic regression analysis separately in patients who required dialysis earlier than 5 years (Early Progressors) and those who required dialysis within 5 to 10 years (Late Progressors) after biopsy. Results: Independent pathological variables predicting progression to ESRD were global sclerosis, segmental sclerosis and fibrous crescents for Early Progressors, and global sclerosis and cellular/fibrocellular crescents for Late Progressors. Four histological grades, HG 1, HG 2, HG 3 and HG 4, were established corresponding to <25{\%}, 25-49{\%}, 50-74{\%} and ≥75{\%} of glomeruli exhibiting cellular or fibrocellular crescents, global sclerosis, segmental sclerosis or fibrous crescents. Eleven (7{\%}) patients in HG 1, 12 (16{\%}) in HG 2, 13 (31{\%}) in HG 3 and 13 (68{\%}) in HG 4 progressed to ESRD. Multivariate logistic analysis revealed that the risk of progression to ESRD was significantly higher in HG 2, 3 and 4 than in HG 1 (odds ratio, 2.4, 5.7 and 27.6 vs. 1.0). Conclusions: Our evidence-based histologic classification can identify the magnitude of the risk of progression to ESRD and is useful for predicting longterm renal outcome in IgAN.",
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T2 - Emphasis on end-stage renal disease

AU - Kawamura, Tetsuya

AU - Joh, Kensuke

AU - Okonogi, Hideo

AU - Koike, Kentaro

AU - Utsunomiya, Yasunori

AU - Miyazaki, Yoichi

AU - Matsushima, Masato

AU - Yoshimura, Mitsuhiro

AU - Horikoshi, Satoshi

AU - Suzuki, Yusuke

AU - Furusu, Akira

AU - Yasuda, Takashi

AU - Shirai, Sayuri

AU - Shibata, Takanori

AU - Endoh, Masayuki

AU - Hattori, Motoshi

AU - Akioka, Yuko

AU - Katafuchi, Ritsuko

AU - Hashiguchi, Akinori

AU - Kimura, Kenjiro

AU - Matsuo, Seiichi

AU - Tomino, Yasuhiko

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N2 - A multicenter case-control study on IgA nephropathy (IgAN) was conducted to develop an evidence-based clinicopathologic classification of IgAN for predicting long-term renal outcome. Methods: Two hundred and eighty-seven patients including those with isolated hematuria or very mild proteinuria were enrolled. During a median follow-up of 9.3 years after biopsy, 49 patients (17%) progressed to end stage renal disease (ESRD). The associations between pathological variables and the need for chronic dialysis was examined by multivariate logistic regression analysis separately in patients who required dialysis earlier than 5 years (Early Progressors) and those who required dialysis within 5 to 10 years (Late Progressors) after biopsy. Results: Independent pathological variables predicting progression to ESRD were global sclerosis, segmental sclerosis and fibrous crescents for Early Progressors, and global sclerosis and cellular/fibrocellular crescents for Late Progressors. Four histological grades, HG 1, HG 2, HG 3 and HG 4, were established corresponding to <25%, 25-49%, 50-74% and ≥75% of glomeruli exhibiting cellular or fibrocellular crescents, global sclerosis, segmental sclerosis or fibrous crescents. Eleven (7%) patients in HG 1, 12 (16%) in HG 2, 13 (31%) in HG 3 and 13 (68%) in HG 4 progressed to ESRD. Multivariate logistic analysis revealed that the risk of progression to ESRD was significantly higher in HG 2, 3 and 4 than in HG 1 (odds ratio, 2.4, 5.7 and 27.6 vs. 1.0). Conclusions: Our evidence-based histologic classification can identify the magnitude of the risk of progression to ESRD and is useful for predicting longterm renal outcome in IgAN.

AB - A multicenter case-control study on IgA nephropathy (IgAN) was conducted to develop an evidence-based clinicopathologic classification of IgAN for predicting long-term renal outcome. Methods: Two hundred and eighty-seven patients including those with isolated hematuria or very mild proteinuria were enrolled. During a median follow-up of 9.3 years after biopsy, 49 patients (17%) progressed to end stage renal disease (ESRD). The associations between pathological variables and the need for chronic dialysis was examined by multivariate logistic regression analysis separately in patients who required dialysis earlier than 5 years (Early Progressors) and those who required dialysis within 5 to 10 years (Late Progressors) after biopsy. Results: Independent pathological variables predicting progression to ESRD were global sclerosis, segmental sclerosis and fibrous crescents for Early Progressors, and global sclerosis and cellular/fibrocellular crescents for Late Progressors. Four histological grades, HG 1, HG 2, HG 3 and HG 4, were established corresponding to <25%, 25-49%, 50-74% and ≥75% of glomeruli exhibiting cellular or fibrocellular crescents, global sclerosis, segmental sclerosis or fibrous crescents. Eleven (7%) patients in HG 1, 12 (16%) in HG 2, 13 (31%) in HG 3 and 13 (68%) in HG 4 progressed to ESRD. Multivariate logistic analysis revealed that the risk of progression to ESRD was significantly higher in HG 2, 3 and 4 than in HG 1 (odds ratio, 2.4, 5.7 and 27.6 vs. 1.0). Conclusions: Our evidence-based histologic classification can identify the magnitude of the risk of progression to ESRD and is useful for predicting longterm renal outcome in IgAN.

KW - End-stage renal disease

KW - IgA nephropathy

KW - Prognosis

KW - Progression

KW - Risk factor

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