Acute Kidney Injury and Remission of Proteinuria in Minimal Change Disease.
Acute Kidney Injury and Remission of Proteinuria in Minimal Change Disease.
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DOI：
10.1016/j.ekir.2022.07.173
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发表时间：
2022-10
影响因子：
6
通讯作者：
Yoshitaka, Isaka
中科院分区：
文献类型：
--
作者：
Yamamoto, Ryohei;Imai, Enyu;Maruyama, Shoichi;Yokoyama, Hitoshi;Sugiyama, Hitoshi;Takeda, Asami;Uchida, Shunya;Tsukamoto, Tatsuo;Tsuruya, Kazuhiko;Akai, Yasuhiro;Nitta, Kosaku;Fukunaga, Megumu;Hayashi, Hiroki;Shoji, Tatsuya;Masutani, Kosuke;Konta, Tsuneo;Katafuchi, Ritsuko;Nishio, Saori;Wada, Takashi;Goto, Shunsuke;Tamai, Hirofumi;Shirasaki, Arimasa;Nagai, Kojiro;Nishino, Tomoya;Yamagata, Kunihiro;Kazama, Junichiro J.;Hiromura, Keiju;Yasuda, Hideo;Sofue, Tadashi;Fujimoto, Shouichi;Mizutani, Makoto;Naruse, Tomohiko;Hiramatsu, Takeyuki;Morozumi, Kunio;Sobajima, Hiroshi;Saka, Yosuke;Ishimura, Eiji;Ito, Takafumi;Ichikawa, Daisuke;Shigematsu, Takashi;Sato, Hiroshi;Narita, Ichiei;Yoshitaka, Isaka
关键词：
结果：日本肾病综合征队列研究是一项针对原发性肾病综合征的5年前瞻性队列研究，旨在评估主要临床结局的发生率和免疫抑制治疗（IST）的有效性。5本研究旨在评估日本肾病综合征队列研究中纳入的113名18岁以上、尿蛋白大于或等于3.5 g/天（如果尿蛋白缺失，尿蛋白与肌酐比值≥3.5 g/gCr）的40家医院IST起始时AKI与缓解和复发发生率之间的关系（补充图S1）。研究方案在补充方法中有详细描述。6由于分别有108例（95.6%）和96例（85.0%）患者在IST治疗2个月内实现尿蛋白< 3.5 g/天（或g/gCr）的非肾病性蛋白尿并得到缓解，因此我们假设在开始IST治疗2个月后，MCD发病前的血清肌酐水平（表现前血清肌酐水平）与MCD发病前的血清肌酐水平相同，该血清肌酐水平用于估计MCD发病前的肾小球滤过率（eGFR）。根据肾脏疾病：改善AKI的全球结局临床实践指南，我们将基线AKI定义为基线血清肌酐水平比发病前血清肌酐水平增加至少0.3 mg/dl或50%。AKI分期定义如下：1期为血清肌酐水平升高至少0.3 mg/dl和/或50% - 99%；2期血清肌酐水平升高100% ~ 199%；第三阶段是血清肌酐水平升高至少200%和/或血清肌酐水平大于或等于4.0 mg/dl。我们评估了prepresentation AKI与缓解蛋白尿定义为尿蛋白的发病率大于0.3克/天(或g / gCr) 8(研究1)。我们也评估的临床效果阿基蛋白尿缓解后复发,这被定义为至少1.0克/天的尿蛋白(g / gCr)和/或试纸尿蛋白≥2 + 2次或更多,在典型的患者MCD,达到缓解之日起2个月内,坚持(研究2)。8
ResultsThe Japan Nephrotic Syndrome Cohort Study is a 5-year prospective cohort study of primary nephrotic syndrome to assess the incidence of major clinical outcomes and the effectiveness of immunosuppressive therapy (IST). 5 The present study aimed to assess the association between AKI and the incidence of remission and relapse in 113 adult patients enrolled in the Japan Nephrotic Syndrome Cohort Study aged 18 years or older, with urinary protein greater than or equal to 3.5 g/day (or urinary protein-to-creatinine ratio≥ 3.5 g/gCr if urinary protein was missing) at IST initiation in 40 hospitals (Supplementary Figure S1). The study protocol is described in Supplementary Methods in detail. 6 Because 108 (95.6%) and 96 (85.0%) patients achieved non-nephrotic proteinuria of urinary protein< 3.5 g/day (or g/gCr) and remission within 2 months of IST, respectively, we assumed that the serum creatinine level before the onset of MCD (prepresentation serum creatinine level) was at the same serum creatinine level 2 months after initiating IST, which was used to estimate the estimated glomerular filtration rate (eGFR) before the onset of MCD (prepresentation eGFR). Based on the Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for AKI, 7 we defined the baseline AKI as an increase in baseline serum creatinine level by at least 0.3 mg/dl or 50% from prepresentation serum creatinine level. AKI stages were defined as follows: stage 1 is an increase in serum creatinine level by at least 0.3 mg/dl and/or 50% to 99%; stage 2 is an increase in serum creatinine level by 100% to 199%; and stage 3 is an increase in serum creatinine level by at least 200% and/or serum creatinine level greater than or equal to 4.0 mg/dl. We assessed the association between prepresentation AKI and the incidence of remission of proteinuria defined as urinary protein of greater than 0.3 g/day (or g/gCr)(study 1). 8 We also assessed the clinical effect of AKI on relapse of proteinuria after remission, which was defined as urinary protein of at least 1.0 g/day (or g/gCr) and/or dipstick urinary protein≥ 2+ continued 2 or more times, in typical patients with MCD, who achieved remission within 2 months of IST (study 2). 8
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影响因子：
2.3
作者：
Nishi S;Ubara Y;Utsunomiya Y;Okada K;Obata Y;Kai H;Kiyomoto H;Goto S;Konta T;Sasatomi Y;Sato Y;Nishino T;Tsuruya K;Furuichi K;Hoshino J;Watanabe Y;Kimura K;Matsuo S
通讯作者：
Matsuo S
影响因子：
13.2
作者：
Chen, CL;Fang, HC;Wang, JS
通讯作者：
Wang, JS
影响因子：
2.3
作者：
Yamamoto, Ryohei;Imai, Enyu;Isaka, Yoshitaka
通讯作者：
Isaka, Yoshitaka
影响因子：
6.1
作者：
Lin SP;Zhu FG;Meng JL;Sun XW;Cui J;Liang S;Yin Z;Sun XF;Cai GY
通讯作者：
Cai GY
影响因子：
2.5
作者：
Komukai, Daisuke;Hasegawa, Takeshi;Yoshimura, Ashio
通讯作者：
Yoshimura, Ashio