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Membranous nephropathy in Japan: analysis of the Japan Renal Biopsy Registry (J-RBR)

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Abstract

Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults. The J-RBR/J-KDR registry developed by the Japanese Society of Nephrology provides nationwide cohort data for epidemiological studies of MN. MN was present in 36.8% of 1,203 primary nephrotic syndrome patients in Japan. In addition, 633 (77.9%) out of 813 MN patients were referred to as “idiopathic,” whereas 22.1% were classified as “secondary” and involved conditions such as systemic lupus erythematosus, drug exposure, infections, cancer, and various collagen diseases. The mean age of the MN patients was 62.2 (2–88) years old, their mean eGFR was 76.7 (7.6–154.6) ml/min/1.73 m2, and 63.3% had hypertension at the time of renal biopsy. On the basis of these findings, half of Japanese idiopathic MN patients have risk factors (age >60, male, or lower eGFR) for end-stage renal failure, and 10% belong to the high-risk group (daily proteinuria of over 8.0 g). Further studies with high-grade evidence should resolve the natural history and therapeutic problems of idiopathic MN in elderly Japanese.

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References

  1. Cattran D. Management of membranous nephropathy: when and what for treatment. J Am Soc Nephrol. 2005;16:1188–94.

    Article  PubMed  Google Scholar 

  2. Glassock RJ. Secondary membranous glomerulonephritis. Nephrol Dial Transplant. 1992;7(Suppl 1):64–71.

    PubMed  Google Scholar 

  3. Yokoyama H, Okuyama H, Yamaya H. Clinicopathological insights into lupus glomerulonephritis in Japanese and Asians. Clin Exp Nephrol. 2011;15:321–30.

    Article  PubMed  Google Scholar 

  4. Ronco P, Debiec H. Podocyte antigens and glomerular disease. Nephron Exp Nephrol. 2007;107:e41–6.

    Article  PubMed  Google Scholar 

  5. Beck LH Jr, Bonegio RG, Lambeau G, Beck DM, Powell DW, Cummins TD, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med. 2009;361:11–21.

    Article  PubMed  CAS  Google Scholar 

  6. Polanco N, Gutierrez E, Covarsi A, Ariza F, Carreno A, Vigil A, et al. Spontaneous remission of nephrotic syndrome in idiopathic membranous nephropathy. J Am Soc Nephrol. 2010;21:697–704.

    Article  PubMed  CAS  Google Scholar 

  7. Shiiki H, Saito T, Nishitani Y, Mitarai T, Yorioka N, Yoshimura A, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan. Kidney Int. 2004;65:1400–7.

    Article  PubMed  Google Scholar 

  8. Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, et al. Committee for Standardization of Renal Pathological Diagnosis and Working Group for Renal Biopsy Database, Japanese Society of Nephrology, Tokyo, Japan: Japan Renal Biopsy Registry: Japan Renal Biopsy Registry: the first nationwide, web-based, and prospective registry system of renal biopsies in Japan. Clin Exp Nephrol. 2011;15:493–503.

    Article  PubMed  Google Scholar 

  9. Research Group on Progressive Chronic Renal Disease. Nationwide and long-term survey of primary glomerulonephritis in Japan as observed in 1,850 biopsied cases. Nephron. 1999;82:205–13.

    Article  Google Scholar 

  10. Li LS, Liu ZH. Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies. Kidney Int. 2004;66:920–3.

    Article  PubMed  Google Scholar 

  11. Gesualdo L, Di Palma AM, Morrone LF, Strippoli G, Schena FP. The Italian experience of the national registry of renal biopsies. Kidney Int. 2004;66:890–4.

    Article  PubMed  Google Scholar 

  12. Rychlik I, Jancova E, Tesar V, Kolsky A, Lacha J, Stejskal J, et al. The Czech registry of renal biopsies. Occurrence of renal diseases in the years 1994–2000. Nephrol Dial Transplant. 2004;19:3040–9.

    Article  PubMed  Google Scholar 

  13. Covic A, Schiller A, Volovat C, Gluhovschi G, Gusbeth-Tatomir P, Petrica L, et al. Epidemiology of renal disease in Romania: a 10 year review of two regional renal biopsy databases. Nephrol Dial Transplant. 2006;21:419–24.

    Article  PubMed  Google Scholar 

  14. Malafronte P, Mastroianni-Kirsztajn G, Betonico GN, Romão JE Jr, Alves AMR, Carvalho MF, et al. Paulista registry of glomerulonephritis: 5-year data report. Nephrol Dial Transplant. 2006;21:3098–105.

    Article  PubMed  Google Scholar 

  15. Polito MG, Moura LA, Kirsztajn GM. An overview on frequency of renal biopsy diagnosis in Brazil: clinical and pathological patterns based on 9,617 native kidney biopsies. Nephrol Dial Transplant. 2010;25:490–6.

    Article  PubMed  Google Scholar 

  16. Chang JH, Kim DK, Kim HW, Park SY, Yoo TH, Kim BS, et al. Changing prevalence of glomerular diseases in Korean adults: a review of 20 years of experience. Nephrol Dial Transplant. 2009;24:2406–10.

    Article  PubMed  Google Scholar 

  17. Korbet SM, Genchi RM, Borok RZ, Schwartz MM. The racial prevalence of glomerular lesions in nephritic adults. Am J Kidney Dis. 1996;27:647–51.

    Article  PubMed  CAS  Google Scholar 

  18. Levey AS, de Jong PE, Coresh J, El Nahas M, Astor BC, Matsushita K, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney Int. 2011;80:17–28.

    Article  PubMed  Google Scholar 

  19. Matsuo S, Imai E, Saito T, Taguchi T, Yokoyama H, Narita I, et al. Guidelines for the treatment of nephrotic syndrome. Jpn J Nephrol. 2011;53:136–41. (article in Japanese).

    Google Scholar 

  20. Ishimitsu T. Points at issue in the Japanese Society of Hypertension’s guidelines for the management of hypertension (JSH2009). Jpn J Nephrol. 2009;51:456–60. (article in Japanese).

    Google Scholar 

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Acknowledgments

The authors greatly acknowledge the help and assistance of their colleagues at the centers and affiliated hospitals who helped with the data collection for the J-RBR/J-KDR. This study was supported in part by the committee of the Japanese Society of Nephrology and a Grant-in-Aid for Progressive Renal Disease Research from the Ministry of Health, Labour, and Welfare of Japan.

Conflict of interest

Three of the authors (HY, TT, and HS) have no conflicts of interest to disclose. One author (SH) was supported by Daiichi-Sankyo Co. Ltd.

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Authors and Affiliations

  1. Division of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan

    Hitoshi Yokoyama

  2. Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Takashi Taguchi

  3. Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

    Hitoshi Sugiyama

  4. Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan

    Hiroshi Sato

Authors
  1. Hitoshi Yokoyama
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  2. Takashi Taguchi
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  3. Hitoshi Sugiyama
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  4. Hiroshi Sato
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Consortia

On behalf of the Committee for the Standardization of Renal Pathological Diagnosis and for Renal Biopsy and Disease Registry in the Japanese Society of Nephrology

Corresponding author

Correspondence to Hitoshi Yokoyama.

Additional information

This article is based on the studies first reported in Epidemiology of membranous nephropathy in Japan (in Japanese). Jpn J Nephrol 2011;53:677–83.

Appendix

Appendix

The following are the initial investigators and institutions who have participated in the project to develop the J-RBR since 2007:

Takao Saito (Fukuoka University), Yukimasa Kohda (Kumamoto University; present address, Hikarinomori Clinic), Shinichi Nishi (Niigata University; present address: Kobe University), Kazuhiko Tsuruya and Yutaka Kiyohara (Kyushu University), Hideyasu Kiyomoto (Kagawa University; present address: Tohoku University), Hiroyuki Iida (Toyama Prefectural Central Hospital), Tamaki Sasaki (Kawasaki Medical School), Makoto Higuchi (Shinshu University), Motoshi Hattori (Tokyo Women’s Medical University), Kazumasa Oka (Osaka Kaisei Hospital; present address: Hyogo Prefectural Nishinomiya Hospital), Shoji Kagami (The University of Tokushima Graduate School), Michio Nagata (University of Tsukuba), Tetsuya Kawamura (Jikei University School of Medicine), Masataka Honda (Tokyo Metropolitan Children’s Medical Center), Yuichiro Fukasawa (KKR Sapporo Medical Center; present address: Sapporo City Hospital), Atsushi Fukatsu (Kyoto University Graduate School of Medicine), Kunio Morozumi (Japanese Red Cross Nagoya Daini Hospital), Norishige Yoshikawa (Wakayama Medical University), Yukio Yuzawa (present address: Fujita Health University) and Seiichi Matsuo (Nagoya University Graduate School of Medicine), Kensuke Joh (Chiba-East National Hospital; present address: Sendai Shakai Hoken Hospital), Hirofumi Makino (Okayama University Graduate School of Medicine).

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Yokoyama, H., Taguchi, T., Sugiyama, H. et al. Membranous nephropathy in Japan: analysis of the Japan Renal Biopsy Registry (J-RBR). Clin Exp Nephrol 16, 557–563 (2012). https://doi.org/10.1007/s10157-012-0593-7

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  • DOI: https://doi.org/10.1007/s10157-012-0593-7

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