Evidence-based clinical practice guidelines for nephrotic syndrome 2014

Nishi, Shinichi; Ubara, Yoshifumi; Utsunomiya, Yasunori; Okada, Koichi; Obata, Yoko; Kai, Hiroyasu; Kiyomoto, Hideyasu; Goto, Shin; Konta, Tsuneo; Sasatomi, Yoshie; Sato, Yoshinobu; Nishino, Tomoya; Tsuruya, Kazuhiko; Furuichi, Kengo; Hoshino, Junichi; Watanabe, Yasuhiro; Kimura, Kenjiro; Matsuo, Seiichi

doi:10.1007/s10157-015-1216-x

Cited by 99 publications

(119 citation statements)

References 69 publications

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“…When we judged the nephrotic state of the patients based on the new criteria for nephrotic syndrome used in Japan [14]; i.e., daily proteinuria (or a UPCR) of more than 3.5 g (or g/ gCr) and serum albumin levels less than 3.0 g/dL or serum total protein levels less than 6.0 g/dL, 297 (253 patients with nephrotic syndrome and 44 patients with nephrotic syndrome with collagen disease/vasculitis)(50.1%) of the 593 patients with MPGN were considered to be nephrotic ( Fig. 1c; Table 3).…”

Section: General Data Of Patientsmentioning

confidence: 99%

Clinical features and pathogenesis of membranoproliferative glomerulonephritis: a nationwide analysis of the Japan renal biopsy registry from 2007 to 2015

et al. 2017

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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.

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Section: General Data Of Patientsmentioning

confidence: 99%

Clinical features and pathogenesis of membranoproliferative glomerulonephritis: a nationwide analysis of the Japan renal biopsy registry from 2007 to 2015

et al. 2017

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“…Low-dose cyclosporine combined with low-dose prednisolone is a recent trend in the treatment of nephrotic syndrome. 17,20 Renal biopsy demonstrated minimal glomerular change on light microscopy and no glomerular deposition by fluorescent immunohistochemistry in the present patient. Glomerular IgE deposition in this patient remains unknown because routine fluorescent immunohistochemical staining did not include IgE.…”

Section: Discussionmentioning

confidence: 91%

“…Three of these 11 patients did not satisfy the criteria for nephrotic syndrome, i.e., proteinuria equal to and greater than 3.5 g/day. 20 Since the year 2000, nephrotic syndrome with Kimura disease has been frequently reported in Chinese patients. [21][22][23][24][25][26] In the review of 10 Japanese patients with Kimura disease associated with proteinuria, renal biopsy confirmed glomerular IgE deposition in only one patient (Case 1 in Table 1) who exhibited a low level of proteinuria (0.6 g/day), and glomerular endocapillary and mesangial proliferation.…”

Section: Discussionmentioning

confidence: 99%

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Nephrotic syndrome during the tapering of oral steroids after pathological diagnosis of Kimura disease from a lacrimal gland mass: case report and review of 10 Japanese patients

Matsuo

Tanaka

Kinomura

2017

JCEH

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JC EH lin xp ematopathol Case Study INTRODUCTIONThe ocular adnexa are supporting tissues for the eye globe, comprising the eyelid, lacrimal gland and sac, extraocular muscles, and orbital interstitial tissue. These sites are frequently affected by lymphoma 1 and inflammatory diseases such as IgG4-related disease.2 Magnetic resonance imaging of ocular adnexal masses cannot differentiate inflammatory diseases from lymphoma. Therefore, excisional biopsy is required to establish the diagnosis and decide the treatment strategy.Kimura disease predominantly occurs in young Asian males and presents as soft subcutaneous granulomas, which are frequently seen in the head and neck. Lymphoid follicular hyperplasia and marked eosinophilic infiltration are the pathological characteristics of Kimura disease, and blood examination commonly reveals eosinophilia and high serum immunoglobulin E (IgE).3-6 Kimura disease rarely manifests as orbital tumors such as lacrimal gland masses. [7][8][9] Pathologically, it remains controversial whether Kimura disease in Asian reports and angiolymphoid hyperplasia with eosinophilia in Western reports are the same entity. 6 In this study, we report a patient with Kimura disease who initially presented with a lacrimal gland mass and then developed nephrotic syndrome one month after the tapering of oral prednisolone. We also reviewed 10 reported Japanese patients with Kimura disease associated with proteinuria. 10-18 CASE REPORTA 42-year-old man noticed upper eyelid swelling on the left side that subsided spontaneously 5 months ago. He again developed left eyelid swelling with left exophthalmos 2 months ago, and was referred to an ophthalmologist. In his past history, he underwent bilateral tonsil extirpation due to otitis media at the age of 5 years. He developed systemic urticaria lasting a week after eating sashimi 3 years ago, and Nephrotic syndrome during the tapering of oral steroids after pathological diagnosis of Kimura disease from a lacrimal gland mass: case report and review of 10 Japanese patients A 42-year-old man with eosinophilia and high serum immunoglobulin E (IgE) developed a lacrimal gland mass on the left side. Excisional biopsy revealed hyperplasia of lymphoid follicles, and infiltration with lymphocytes and eosinophils around lacrimal gland acini, leading to the pathological diagnosis of Kimura disease. IgE-positive cells were mainly found along follicular dendritic cells, and a small number of IgG4-positive cells was present. One month after oral prednisolone was started at 40 mg daily and tapered to 10 mg daily, he developed lower leg edema on both sides and marked proteinuria (10.8 g/day). Renal biopsy showed no glomerular abnormalities, no immunoglobulin deposition, and no tubulointerstitial infiltration with eosinophils, leading to the diagnosis of minimal change nephrotic syndrome. Proteinuria subsided in response to an increased dose of prednisolone to 30 mg daily. Proteinuria relapsed three times in the following 5 years when oral prednisolone was tapered. In conclus...

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“…A Cox regression model was used to identify factors affecting the renal outcome. Deterioration of renal function was defined as elevation of the serum creatinine value to 1.5 times the level determined at the time of the biopsy and to a level higher than 1.0 mg/dL [12]. Patients whose urinary protein at the time of renal biopsy was 3.5 g/day or more were classified into the nephrotic syndrome group and patients in whom the urinary protein excretion was less than 3.5 g/day were classified into the chronic nephritic syndrome group.…”

Section: Assessment Of Laboratory Datamentioning

confidence: 99%

Long-Term Outcome of 102 Cases of Lupus Nephritis: A Single-Center Cohort Study in Japan

Kodama¹,

Uchida²,

Karasawa³

et al. 2017

IJCM

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Background: The mortality rate is higher in SLE patients with lupus nephritis (LN) than in those without nephropathy. Objectives: The aim of this study was to identify the factors affecting the long-term renal outcome in 102 patients with LN. Methods: This was a retrospective cohort study. Logistic regression analysis was used in a model to determine how independent variables predicted the outcome. The survival analysis was based on the Kaplan-Meier curve with subjects censored for death. Results: The 15-year survival rate was 93.5%, and the renal function non-deterioration rate was 78.3%. No influence of individual types of immunosuppressant drugs used was found on the renal function deterioration rate. In this study, the results of analysis identified only daily urinary protein excretion level as having any significant effect on the risk of progression of LN to renal failure. Conclusions: These results suggest that remission induction therapy and maintenance therapy focused on long-term preservation of renal function need to be selected for LN patients with a high daily urinary protein value at the start of treatment and for LN patients who fail to show any reduction of the daily urinary protein excretion level to 0.5 g or less at one year after the biopsy.

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Evidence-based clinical practice guidelines for nephrotic syndrome 2014

Cited by 99 publications

References 69 publications

Clinical features and pathogenesis of membranoproliferative glomerulonephritis: a nationwide analysis of the Japan renal biopsy registry from 2007 to 2015

Clinical features and pathogenesis of membranoproliferative glomerulonephritis: a nationwide analysis of the Japan renal biopsy registry from 2007 to 2015

Nephrotic syndrome during the tapering of oral steroids after pathological diagnosis of Kimura disease from a lacrimal gland mass: case report and review of 10 Japanese patients

Long-Term Outcome of 102 Cases of Lupus Nephritis: A Single-Center Cohort Study in Japan

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