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Erschienen in: Clinical and Experimental Nephrology 6/2013

01.12.2013 | Original Article

Age and prediction of remission and relapse of proteinuria and corticosteroid-related adverse events in adult-onset minimal-change disease: a retrospective cohort study

verfasst von: Maki Shinzawa, Ryohei Yamamoto, Yasuyuki Nagasawa, Susumu Oseto, Daisuke Mori, Kodo Tomida, Terumasa Hayashi, Masaaki Izumi, Megumu Fukunaga, Atsushi Yamauchi, Yoshiharu Tsubakihara, Hiromi Rakugi, Yoshitaka Isaka

Erschienen in: Clinical and Experimental Nephrology | Ausgabe 6/2013

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Abstract

Background

In adult-onset minimal-change disease (MCD) the predictors of remission and relapse of proteinuria and corticosteroid-related adverse events remain unknown.

Methods

The multicenter retrospective cohort study, the STudy of Outcomes and Practice patterns of Minimal-Change Disease (STOP-MCD), included 142 adult-onset MCD patients in 5 nephrology centers in Japan. Primary outcomes were first remission of proteinuria defined by urinary protein (UP) <0.3 g/day, UP/creatinine ratio (UPCR) <0.3, and/or negative/trace by dipstick test and first relapse of proteinuria defined by UP ≥1.0 g/day, UPCR ≥1.0, and/or dipstick test ≥1+ followed by immunosuppressive therapy. Secondary outcomes were corticosteroid-related adverse events.

Results

During the median 3.6 (interquartile range, 2.0–6.9) years of the entire observational period, 136 (95.8 %) and 79 (58.1 %) patients developed at least 1 remission and 1 recurrence within a median of 15 (10–34) days and 0.90 (0.55–1.57) years, respectively. Compared with younger patients aged 15–29 years at kidney biopsy, elderly patients aged ≥60 years developed remission significantly later [hazard ratio 0.53 (95 % confidence interval 0.32–0.88)], while older patients aged ≥45 years were at a significantly lower risk of relapse [45–59 years, 0.46 (0.22–0.96); 60–83 years, 0.39 (0.21–0.74)]. However, older patients were significantly more vulnerable to severe infection, diabetes, and cataract as compared with younger patients.

Conclusion

Younger patients had a higher risk of relapse while older patients had a lower risk of relapse but a higher risk of corticosteroid-related adverse events.
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Metadaten
Titel
Age and prediction of remission and relapse of proteinuria and corticosteroid-related adverse events in adult-onset minimal-change disease: a retrospective cohort study
verfasst von
Maki Shinzawa
Ryohei Yamamoto
Yasuyuki Nagasawa
Susumu Oseto
Daisuke Mori
Kodo Tomida
Terumasa Hayashi
Masaaki Izumi
Megumu Fukunaga
Atsushi Yamauchi
Yoshiharu Tsubakihara
Hiromi Rakugi
Yoshitaka Isaka
Publikationsdatum
01.12.2013
Verlag
Springer Japan
Erschienen in
Clinical and Experimental Nephrology / Ausgabe 6/2013
Print ISSN: 1342-1751
Elektronische ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-013-0793-9

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