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2 results on '"Arimasa, Shirasaki"'

1. Predictors of early remission of proteinuria in adult patients with minimal change disease: a retrospective cohort study

Author

Ryohei Yamamoto, Enyu Imai, Shoichi Maruyama, Hitoshi Yokoyama, Hitoshi Sugiyama, Asami Takeda, Shunya Uchida, Tatsuo Tsukamoto, Kazuhiko Tsuruya, Yasuhiro Akai, Kosaku Nitta, Megumu Fukunaga, Hiroki Hayashi, Kosuke Masutani, Takashi Wada, Tsuneo Konta, Ritsuko Katafuchi, Saori Nishio, Shunsuke Goto, Hirofumi Tamai, Arimasa Shirasaki, Tatsuya Shoji, Kojiro Nagai, Tomoya Nishino, Kunihiro Yamagata, Junichiro J. Kazama, Keiju Hiromura, Hideo Yasuda, Makoto Mizutani, Tomohiko Naruse, Takeyuki Hiramatsu, Kunio Morozumi, Hiroshi Sobajima, Yosuke Saka, Eiji Ishimura, Daisuke Ichikawa, Takashi Shigematsu, Tadashi Sofue, Shouichi Fujimoto, Takafumi Ito, Hiroshi Sato, Ichiei Narita, Yoshitaka Isaka, and JNSCS Investigators

Subjects
Medicine, Science
Abstract

Abstract Previous studies reported conflicting results regarding an association between serum albumin concentration and the cumulative incidence of remission of proteinuria in adult patients with minimal change disease (MCD). The present study aimed to clarify the clinical impact of serum albumin concentration and the cumulative incidence of remission and relapse of proteinuria in 108 adult patients with MCD at 40 hospitals in Japan, who were enrolled in a 5-year prospective cohort study of primary nephrotic syndrome, the Japan Nephrotic Syndrome Cohort Study (JNSCS). The association between serum albumin concentration before initiation of immunosuppressive treatment (IST) and the cumulative incidence of remission and relapse were assessed using multivariable-adjusted Cox proportional hazards models. Remission defined as urinary protein 1.5 g/dL) showed significantly slow remission. In conclusion, lower serum albumin concentration and higher eGFR were associated with earlier remission in MCD, but not with relapse.

Published
2022
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2. Incidence of remission and relapse of proteinuria, end-stage kidney disease, mortality, and major outcomes in primary nephrotic syndrome: the Japan Nephrotic Syndrome Cohort Study (JNSCS)

Author

Yoshitaka Isaka, Hajime Hasegawa, Takeyuki Hiramatsu, Hitoshi Yokoyama, Ichiei Narita, Naoki Kashihara, Kosuke Masutani, Seiichi Matsuo, Kunihiro Yamagata, Tatsuo Tsukamoto, Hiroshi Sato, Kazuhiko Tsuruya, Yusuke Suzuki, Tomohiko Naruse, Shoichi Maruyama, Hiroshi Sobajima, Shunsuke Goto, Arimasa Shirasaki, Hideo Yasuda, Hirofumi Tamai, Hirokazu Okada, Shunya Uchida, Makoto Mizutani, Takashi Wada, Kiyoki Kitagawa, Satoshi Suzuki, Toshinobu Sato, Keiju Hiromura, Saori Nishio, Yoshio Terada, Kosaku Nitta, Ritsuko Katafuchi, Tomoya Nishino, Eiji Ishimura, Kojiro Nagai, Tsuneo Konta, Tetsushi Mimura, Yugo Shibagaki, Kunio Morozumi, Junichiro James Kazama, Hiroki Hayashi, Hitoshi Sugiyama, Megumu Fukunaga, Shizunori Ichida, Yasuhiro Akai, Toshiyuki Akahori, Takashi Shigematsu, Takafumi Ito, Asami Takeda, Enyu Imai, Satoshi Tanaka, Tatsuya Shoji, Yoshiro Fujita, Tadashi Sofue, Yosuke Saka, Ryohei Yamamoto, and Shouichi Fujimoto

Subjects
Male, Nephrotic Syndrome, Physiology, Glomerulonephritis, Membranous, Cohort Studies, Primary nephrotic syndrome, Focal segmental glomerulosclerosis, Japan, Recurrence, Medicine, Minimal change disease, Proteinuria, Glomerulosclerosis, Focal Segmental, Incidence (epidemiology), Incidence, Remission Induction, Diabetes, End-stage kidney disease, Middle Aged, Hospitalization, Nephrology, Cardiovascular Diseases, Creatinine, Female, Original Article, medicine.symptom, Cohort study, Infection, Immunosuppressive Agents, Adult, medicine.medical_specialty, Infections, Membranous nephropathy, Physiology (medical), Internal medicine, Diabetes Mellitus, Humans, Hypoglycemic Agents, Mortality, Aged, business.industry, Nephrosis, Lipoid, medicine.disease, Kidney Failure, Chronic, business, Nephrotic syndrome, Kidney disease, Follow-Up Studies
Abstract

Background Despite recent advances in immunosuppressive therapy for patients with primary nephrotic syndrome, its effectiveness and safety have not been fully studied in recent nationwide real-world clinical data in Japan. Methods A 5-year cohort study, the Japan Nephrotic Syndrome Cohort Study, enrolled 374 patients with primary nephrotic syndrome in 55 hospitals in Japan, including 155, 148, 38, and 33 patients with minimal change disease (MCD), membranous nephropathy (MN), focal segmental glomerulosclerosis (FSGS), and other glomerulonephritides, respectively. The incidence rates of remission and relapse of proteinuria, 50% and 100% increases in serum creatinine, end-stage kidney disease (ESKD), all-cause mortality, and other major adverse outcomes were compared among glomerulonephritides using the Log-rank test. Incidence of hospitalization for infection, the most common cause of mortality, was compared using a multivariable-adjusted Cox proportional hazard model. Results Immunosuppressive therapy was administered in 339 (90.6%) patients. The cumulative probabilities of complete remission within 3 years of the baseline visit was ≥ 0.75 in patients with MCD, MN, and FSGS (0.95, 0.77, and 0.79, respectively). Diabetes was the most common adverse events associated with immunosuppressive therapy (incidence rate, 71.0 per 1000 person-years). All-cause mortality (15.6 per 1000 person-years), mainly infection-related mortality (47.8%), was more common than ESKD (8.9 per 1000 person-years), especially in patients with MCD and MN. MCD was significantly associated with hospitalization for infection than MN. Conclusions Patients with MCD and MN had a higher mortality, especially infection-related mortality, than ESKD. Nephrologists should pay more attention to infections in patients with primary nephrotic syndrome.

Published
2020

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