Academic
Publications
Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan

Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan,10.1111/j.1523-1755.2004.00518.x,Kidney Internationa

Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan   (Citations: 18)
BibTex | RIS | RefWorks Download
Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan.BackgroundIdiopathic membranous nephropathy (IMN) is a representative form of refractory nephrotic syndrome in Japan. Although IMN is thought to run a more benign course in Japanese than in the Caucasian population, risk factors and appropriate treatment are controversial issues.MethodsThe research group supported by a grant for “Progressive Renal Disease” from the Ministry of Health, Labor and Welfare, Japan, carried out a national survey of patients with IMN and nephrotic syndrome. Of 1066 nephrotic patients with histopathologically proven IMN registered from 1975 to 1993 in 85 institutions, 949 patients were studied.ResultsThe overall renal survival rates were 95.8%, 90.3%, 81.1%, and 60.5% at 5, 10, 15, and 20 years after diagnosis, respectively. When clinical and histopathologic features at onset of nephrotic syndrome were evaluated by multivariate analysis, male gender, old age (≥60 years), high serum creatinine concentration (≥1.5 mg/dL), and the development of tubulointerstitial lesions (≥20% of the biopsy sample area) were significant predictors of progression to end-stage renal disease (ESRD). The renal survival rate in patients on steroid therapy was significantly higher than in patients on supportive therapy alone. Patients achieving a remission showed a significant reduction of risk for progression.ConclusionIMN is a disease with a comparatively good prognosis in Japan even when it is associated with nephrotic syndrome. Steroid therapy, which has not been recommended for IMN in most review articles, seems to be useful at least for Japanese patients. In particular, a remission from heavy proteinuria likely results in a favorable outcome.
Journal: Kidney International - KIDNEY INT , vol. 65, no. 4, pp. 1400-1407, 2004
Cumulative Annual
View Publication
The following links allow you to view full publications. These links are maintained by other sources not affiliated with Microsoft Academic Search.
    • ...Refractory nephrotic syndrome is a collective term for diseases that do not result in complete remission or incomplete remission type I within 6 months despite various treatments (including combination of adrenal steroids and immunosuppressive drugs) and commonly lead to endstage renal failure with persistent proteinuria and appearance of edema [1, 2]. We previously found that in 3 patients with refractory nephrotic syndrome subjected to ...

    Satoshi Morimotoet al. A patient with refractory nephrotic syndrome withdrawn from peritoneal...

    • ... In support of this concept, a retrospective analysis from Japan suggested that a 4-week course of steroids in patients with IMN led to improved renal survival...

    Howard A. Austin IIIet al. Controversies in the treatment of idiopathic membranous nephropathy

    • ...Primers for CCL13 were forward 5′-aagtctctgcagtgcttctgt-3′ and reverse 5′-tgatcacatagctcttcagcc-3′. Primers for HSPC159 were forward 5′-tttgagctctccagttcaagc-3′ and reverse 5′-attgcaaagctctctgggttg-3′. As an internal control, we used primers for GAPDH: forward 5′-atggctatgatggaggtccag-3′ and reverse 5′-ttgtcctgcatctgcttcagc-3′. We confirmed that each of PCR products had a single band on agarose gel electrophoresis, and that each of sequence data was correct.Real-time RT-PCR reaction was carried out in a final volume of 20 μl containing 10 μl DNA Master Hybridization Probe 2X (Qiagen), 1 μl of 10 pmol forward and reverse primers, 1 μl of cDNA, and 7 μl of water, according to the manufacturer’s instruction. After an initial denaturation step at 95°C for 900 s, temperature cycling was initiated. Each cycle consisted of denaturation at 95°C for 15 s, hybridization at 60°C (for GAPDH), at 63°C (for HSPC159) or 66°C (for CCL-13) for 20 s, and elongation at 72°C for 20 s, using a LightCycler (Roche Diagnostics, Mannheim, Germany). A total of 45 cycles were performed. Each sample was run in triplicate. Analyses of quantitative real-time RT-PCR curves were determined by LightCycler 3.5 software (Roche Diagnostics). For relative quantification of each mRNA expression, GAPDH mRNA expression was used as a control.Statistical MethodsData are expressed as mean ± SD. Data were analyzed using Wilcoxon t test and Mann-Whitney U tests. Relations between levels of proteinuria and CCL13 and HSPC159mRNA expression levels in PBMC were examined by the Spearman’s correlation coefficient rank test. A p value <0.05 was regarded as statistically significant.ResultsPatientsTable 1 summarizes profiles and data of 24 patients with MCNS and 10 patients with nephrotic syndrome due to MN. There was no significant difference between the eGFR in MCNS and MN patients. The majority of patients with MN went into remission with steroids only. It is known that MN is a disease with a comparatively good prognosis in Japan even when it is associated with nephrotic syndrome. Steroid therapy, which has not been recommended for MN in most review articles, seems to be useful at least for Japanese patients [...

    Atsushi Komatsudaet al. Gene Expression Profiling of Peripheral Blood Mononuclear Cells from P...

    • ...90 Prognosis might also be influenced by racial origin since long-term outcome in the Asian population (Japanese) with MGN is significantly better than Caucasians...

    D C Cattranet al. Cyclosporin in idiopathic glomerular disease associated with the nephr...

Sort by: