Renal disease in the elderly and the very elderly Japanese: analysis of the Japan Renal Biopsy Registry (J-RBR)

Yokoyama, Hitoshi; Sugiyama, Hiroshi; Sato, Hiroshi; Taguchi, Takashi; Nagata, Michio; Matsuo, Seiichi; Makino, Hírofumi; Watanabe, Tsuyoshi; Saito, Takao; Kiyohara, Yutaka; Nishi, Shinichi; Iida, Hiroyuki; Morozumi, Kunio; Fukatsu, Atsushi; Sasaki, Tatsuya; Tsuruya, Kazuhiko; Kohda, Yukimasa; Higuchi, Makoto; Kiyomoto, Hideyasu; Goto, Shin; Hattori, Motoshi; Hataya, Hiroshi; Kubo, Shoji; Yoshikawa, Norishige; Fukasawa, Yuichiro; Ueda, Yoshihiko; Kitamura, Hiroshi; Shimizu, Akira; Oka, Kunihiro; Nakagawa, Naoki; Ito, Takafumi; Uchida, Shunya; Furuichi, Kengo; Nakaya, Izaya; Umemura, Satoshi; Hiromura, Keiju; Yoshimura, Mitsuhiro; Hirawa, Nobuhito; Sügimura, Takashi; Fukagawa, Masafumi; Hiramatsu, Masayuki; Terada, Yoshio; Uemura, Osamu; Kawata, Tetsuya; Matsunaga, Akira; Kuroki, Aki; Mori, Yoshihide; Matsumoto, Koji; Yoshida, Haruyoshi

doi:10.1007/s10157-012-0673-8

Cited by 90 publications

(67 citation statements)

References 21 publications

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“…The incidence of hypertension in the older group was significantly higher than in the younger group. In the incidence data, proteinuria was significantly different between the groups [13,24]. Moreover, other studies also found proteinuria was significantly different between the groups [18,20,21].…”

Section: Resultsmentioning

confidence: 88%

“…Three studies found baseline renal function of the older groups was generally worse than that of the younger groups [13,21,24], but the time between disease onset and diagnosis in the older group and the younger group was not significantly different, which proves that aging itself can damage renal function in IgAN patients and adversely impact IgAN prognosis.…”

Section: Resultsmentioning

confidence: 99%

“…The longest mean follow- up time was 4.9 years, and the shortest was 23.5 months. Four studies were multi-center studies [7,13,23,24]. The age limit for the older group in the 4 studies was 50 years old [12,13,18,20].…”

Section: Resultsmentioning

confidence: 99%

“…1) [7,12,13,18,20,21,22,23,24]. One cross-sectional study and 2 duplicated trials were excluded [19,25,26].…”

Section: Resultsmentioning

confidence: 99%

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Aging Promotes Progression of IgA Nephropathy: A Systematic Review and Meta-Analysis

et al. 2013

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Background: There has been considerable interest in whether old age is associated with IgA nephropathy (IgAN) progression, which is still controversial. Methods: We searched multiple databases for studies published from 1980 to 2012. The inclusion criteria were case-control, cohort studies published in any language. The included studies needed to have an older group. IgAN was proven by biopsy. Results: We included 9 studies with a total of 6,543 patients. The meta-analyses of other risk factors between the older group (>50 years old) and the non-older group (15-50 years old) found significant differences in the presence of hypertension, proteinuria, serum cholesterol levels and baseline renal function. In the overall analysis, compared to the non-older group, older age significantly increased the incidence of developing end-stage renal disease [ESRD; relative risk (RR) random model 1.95; 95% CI: 1.27-3.01]. In the subgroup analyses, we found the age limit and traditional risk factors of IgAN may be the sources of heterogeneity between studies. Moreover, the RR (2.56) of the Asian countries was much higher than the RR (1.11) of the European countries. Conclusions: This comprehensive review revealed that old age is a real risk factor for IgAN progression to ESRD. The incidence of ESRD in the older IgAN patients was 1.95 times higher than that in the non-older IgAN patients. Moreover, the risk of IgAN progression to ESRD of the older patients in Asia was higher than that of the older patients in Europe.

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Section: Resultsmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…1) [7,12,13,18,20,21,22,23,24]. One cross-sectional study and 2 duplicated trials were excluded [19,25,26].…”

Section: Resultsmentioning

confidence: 99%

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Aging Promotes Progression of IgA Nephropathy: A Systematic Review and Meta-Analysis

et al. 2013

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“…According to the Japan Renal Biopsy Registry [2], MCNS accounts for 13.8 % of nephrotic syndrome cases in the elderly ([65 years). There has been an increasing incidence of patients with a variety of complications at the time of nephrotic syndrome onset, especially in the elderly.…”

Section: Introductionmentioning

confidence: 99%

A case of minimal change nephrotic syndrome with hypothyroidism deterioration

et al. 2015

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A 73-year-old woman with Graves' disease underwent total thyroidectomy and was being treated with levothyroxine. She developed edema in the lower region of both legs 1 month before hospitalization. She had a high concentration of urine protein and was hospitalized for further assessment. A urine protein concentration of 4.4 g/day was observed, and she was diagnosed with minimal change nephrotic syndrome (MCNS) after kidney biopsy. The patient's thyroid function had declined, as indicated by a thyroid-stimulating hormone (TSH) level of 139.0 lIU/mL and a free thyroxine (fT4) level of 0.66 ng/ dL. She was prescribed 40 mg/day of prednisolone (PSL) and achieved remission. fT4 level normalized on the 36th hospital day. She was in remission subsequently. However, MCNS recurred when PSL was tapered to 10 mg/day. When she was rehospitalized, thyroid function decline was noted once more, with a TSH level of 29.8 lIU/mL and an fT4 level of 0.74 ng/dL. Her oral PSL dose was increased to 30 mg/day, but she did not achieve remission. However, she achieved remission after steroid pulse therapy. After remission, the thyroid function normalized. During the course of her treatment, the levothyroxine dose was maintained at 87.5 lg/day. Therefore, we predicted that the loss of thyroid hormone in urine due to nephrotic syndrome may have led to the aggravation of hypothyroidism. We have reported this case because of its rarity.

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Glomerulopathies in the Elderly

Navaratnarajah

Willicombe

2019

Clinical Nephrogeriatrics

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Renal disease in the elderly and the very elderly Japanese: analysis of the Japan Renal Biopsy Registry (J-RBR)

Abstract: Renal biopsy is a valuable diagnostic tool, even in elderly and very elderly Japanese patients. In the future, modified clinical guidelines for elderly renal disease should be developed.

Cited by 90 publications

References 21 publications

Aging Promotes Progression of IgA Nephropathy: A Systematic Review and Meta-Analysis

Aging Promotes Progression of IgA Nephropathy: A Systematic Review and Meta-Analysis

A case of minimal change nephrotic syndrome with hypothyroidism deterioration

Glomerulopathies in the Elderly

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